Essential Job Functions: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. • Assesses the psychosocial status of patients and communicates findings to the registered nurse and other members of the interdisciplinary group. • Carries out social evaluations, including family dynamics, caregiver abilities, communication patterns, high risks for suicide, neglect or abuse and plans intervention based on evaluation findings. Counsels patient and family/caregivers as needed in relationship to stress, and other identified coping difficulties. Provides crisis intervention when necessary. • Assesses for, and educates interdisciplinary group, on any special needs related to the culture of the patient and family. Includes communication, role of family, space, and any special traditions or taboos. • Maintains clinical records on all patients referred to social work. • Point of Service documentation is an expectation of all clinical personnel for quality care, accuracy, and communication standards. The clinician is expected to appropriately document at Point of Service, have timely synchronization of patient data & effectively communicate with the Patient Care Team. • Educates patients and families on, and assists in, preparation of advanced directives. • Provides information and referral services for organization patients and families/caregivers regarding practical and environmental needs. • Provides information to patients and families/caregivers and community agencies. • Serves as liaison between patients and families/caregivers and community agencies. • Maintains collaborative relationships with organization personnel to support patient care. •Maintains and develops contracts with public and private agencies as resources for patient and personnel. • Participates in the development of the plan of care, involving the patient and family, and attends regularly scheduled interdisciplinary group meetings, assisting the team in recognizing the effects of the psychosocial stresses on the symptoms of the terminal illness. • Participates in discharge planning when needed. • Other duties as assigned. Qualifications: • Minimum of one (1) year experience in health care. • Experience in a long term care setting preferred. • Bachelor’s degree preferred. • Current Massachusetts licensure: LCSW or LICSW • Demonstrates good verbal and written communication, and organization skills. Physical Requirements and Working Conditions: Will meet all physical requirements of the position as identified by the facility policies and procedures related to functional job analysis. Other Duties: Please note this job description is not designed to cover or contain comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.