Job Description

The Clinical Social Worker II assigned to the Outpatient Renal Center provides professional clinical social work services to patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) receiving outpatient dialysis care. Primary responsibilities include psychosocial assessment, crisis intervention, brief therapeutic counseling, complex care coordination, and continuity planning across the healthcare continuum.

The Clinical Social Worker II collaborates and coordinates with nephrology, nursing, case management, psychiatry, and ancillary services to address psychosocial factors that impact treatment adherence, patient safety, and health outcomes, and provides resources and services to address a patient's psychosocial needs. The incumbent practices within the scope of professional clinical social work, adheres to UCSF policies and regulatory standards, and supports UCSF's mission and Everyday PRIDE values.

DEPARTMENT DESCRIPTION:

The Outpatient Renal Center provides professional clinical social work services to patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) receiving outpatient dialysis care.

Responsibilities

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

80
Yes

• Provide comprehensive psychosocial assessment, crisis intervention, counseling, and referral services to all ESRD patients receiving outpatient dialysis services (Ward 17).
• Evaluate each patient at admission and ensure required psychosocial documentation and treatment-related forms are completed prior to initiation of hemodialysis.
• Develop and implement individualized plans of care supporting social functioning, psychological adjustment to chronic kidney disease, and adherence to dialysis treatment.
• Conduct annual psychosocial reassessments and update care plans accordingly.
• Identify and address psychosocial barriers impacting dialysis adherence, including housing instability, transportation challenges, financial hardship, and insurance limitations.
• Initiate and follow up on insurance status; assist patients with Medicare, Medi-Cal, or other eligibility applications; and collaborate with hospital eligibility and dialysis business office teams to resolve insurance and billing issues.
• Provide assessment, counseling, and referral for behavioral health services, including substance use treatment and smoking cessation programs.
• Facilitate advance care planning discussions as appropriate and collaborate with providers regarding disposition planning.
• Coordinate transportation needs and maintain communication with ward clerk regarding patient transportation lists to support treatment adherence.
• Arrange vacation dialysis and coordinate with receiving dialysis centers and administrative staff as needed.
• Collaborate closely with nephrologists, nurses, pharmacists, case managers, and other interdisciplinary team members; participate in patient care conferences for both Hemodialysis and Home Dialysis units.
• Present relevant psychosocial patient data at monthly CQI meetings and contribute to interdisciplinary treatment planning discussions.
• Provide patient and family education regarding ESRD, dialysis modalities, transplant pathways, and available community resources (e.g., American Kidney Fund, National Kidney Foundation).
• Coordinate and support patient social support activities and resource-sharing initiatives when appropriate.
• Work collaboratively with inpatient social workers and eligibility staff to initiate insurance processes for newly diagnosed chronic dialysis patients and assist with discharge planning to outpatient dialysis.
• Coordinate transportation and outpatient dialysis scheduling for Ward 17 patients transitioning from inpatient to outpatient care.

20
Yes
Administrative and Other Duties:

• Maintain timely, accurate, and complete documentation in the electronic medical record consistent with UCSF standards and regulatory requirements.
• Track required psychosocial updates and maintain compliance with dialysis program documentation standards.
• Participate in interdisciplinary team meetings, case conferences, CQI activities, and quality improvement initiatives.
• Communicate effectively with Renal Center team members to support coordinated patient care.
• Attend department meetings, hospital in-services, and professional development activities related to renal social work practice, including relevant National Kidney Foundation meetings as appropriate.
• Comply with all UCSF policies, regulatory requirements, and standards relevant to clinical social work practice.

100%
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Qualifications

MINIMUM REQUIREMENTS:

• Master's degree from an accredited school of social work, and possession of the requirements necessary for application for licensure as a clinical social worker as determined by the California Board of Behavioral Science Examiners; or an equivalent combination of education and experience; and knowledge and abilities essential to the successful performance of the duties assigned to the position;
• Demonstrated clinical experience in healthcare or behavioral health settings serving medically complex or vulnerable populations.
• Strong written and oral communication, documentation, organizational, and interdisciplinary collaboration skills.
• Ability to work effectively within an outpatient interdisciplinary medical team.
• Basic computer and electronic medical record proficiency.

PREFERRED:

• Experience working with ESRD, dialysis, transplant, or chronic illness populations.
• Experience assisting patients with Medicare/Medi-Cal enrollment and healthcare benefits navigation.
• Training in trauma-informed care, motivational interviewing, or behavioral health interventions.
• Bilingual skills are desirable.

LICENSES/CERTIFICATIONS:

• Possession of the requirements necessary for application for licensure as a clinical social worker as determined by the California Board of Behavioral Science Examiners.

Salary Information

The final salary and offer components are subject to additional approvals based on UC policy.

Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement.

To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html