Associate Director of Social Work - Cardiology Maternal Home, MPA Healthcare Improvement *Grant Funded*

Empower Every New Yorker - Without Exception - to Live the Healthiest Life Possible

NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city's five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Job Description

Under the direction of the Senior Director with latitude for independent judgement, the Cardiology Maternal Home Associate Director of Social Work is responsible for planning and care coordination for patients between two ambulatory service lines at Kings County Hospital-specifically, its OBGYN practice and its Cardiology practice. This role will also be responsible for working closely with the Community Liaison Consultant to facilitate referrals from local community-based organizations.

The Cardiology Maternal Home Associate Director of Social Work plans and coordinates the care necessary to support birthing persons with cardiac disease or chronic disease risk at Kings County Hospital across their pregnancy, childbirth and post-partum care journeys. The primary goal of this role is to improve the population health of obstetrical patients, by helping to reduce the incidence of dual exposure from cardiac disease and/or associated risk factors, and severe maternal morbidity (SMM) and maternal mortality (MM). This position will also contribute to defining key features of this role for replication/expansion to other facilities within the NYC Health + Hospitals system.

QUALIFICATIONS FOR THE JOB:

• Experience working with prenatal and post-partum patients with medical and psychosocial needs. Some patients may be determined to be at a higher risk for a poor pregnancy outcome.
• Utilizing population management data and resources to identify cardiac-obstetrics patients and facilitate appropriate support and resources and care management.
• Experience providing patient outreach, implementing appropriate evidence-based guidelines, monitoring care plan compliance and removing barriers to success.
• Facilitating patient engagement with their medical home, assisting with access to and navigation of the health care system.
• Conduct review(s) of established workflows, to include internal patient referral for behavioral health and integrated behavioral health services. Collaborate with ambulatory care operations to optimize referral access and closed loop referrals across the prenatal and postpartum spectrum, as well as Cardiology, Emergency Department, and as appropriate, Pediatrics.
• Documenting referrals and interventions in the patient's electronic medical record, according to guidelines for care and social work billing.
• Participating in care team meetings, performance improvement and patient satisfaction initiatives.
• Reporting issues and system barriers to efficient and effective care management.
• Maintaining compliance with organizational policies, procedures and evidence-based guidelines.
• Producing monthly reports to further inform care improvements and management of the Maternal Home program.

In addition, the Cardiology Maternal Home Social Worker will:

• Support the ongoing operations by evaluating treatment linkages and/or evidence based supportive programs related to pregnancy designed to improve patient outcomes.
• Evaluate the behavioral health needs of clients and provide supportive counseling to patients in the program with pregnancy associated needs.
• Work closely with the Community Liaison consultant to coordinate external referrals for pregnant individuals who may have heightened risk or active cardiac disease for care
• Support definition and refinement of the Cardiology Maternal Home Associate Director of Social role in preparation for system expansion
• Provide feedback throughout development of staff and community member trainings on cardio-obstetrics and maternal health risks
• Coordinate meetings with other Maternal Home team members and clinicians to review patient statuses, and discuss appropriate interventions and referrals.
• Attend regular meetings of program leadership including Social Work meetings (local/corporate) and ensure contact with the program director and manager
• Any other related duties as assigned

Minimum Qualifications
1. Licensure (LMSW or LCSW) issued by The New York State Education Department (NYSED); and,
2. Six (6) years of experience in Clinical Social Work, of which three (3) years are in a health care or medical care setting including psychiatric and medical social work, and three (3) years in a supervisory, consultative and administrative capacity in a organization adhering to acceptable standards with knowledge of administration, with administrative and managerial skills and abilities; or,
3. A satisfactory completion of training and experience. However, all applicants/incumbents must possess licensure as described in (1) above at the time of appointment; and,
4. Demonstrated ability to function productively and cooperatively with Director of Social Work, Medical Staff, and Administrative Staff and to supervise effectively.

Department Preferences

Knowledge, Skills, Abilities and other Requirements:

• High risk obstetric care for improving access to medical, psychosocial, mental and behavioral health and or emotional support, assessing socioeconomic needs, providing nutrition and education guidance on topics such as breastfeeding and parenting support.
• Maternal and child health
• Counseling and psychology background
• Cardiac disease and/or chronic disease risk, including maternal morbidity and mortality
• Demonstrated relationship building skills

If applying online, please include your cover letter in the same file attachment with your uploaded resume.

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs