Care Coordination Social Worker

Preferra Insurance; Pasadena (TX); Hybrid; USD 51,000 - 111,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement savings options

Wellness programs

Job summary

Oak Street Health is seeking a Medical Social Worker to support psychosocial needs of patients within Oak Street Health Centers. The role includes assessments, advocacy, and care coordination for high-risk patients and their caregivers to improve health status and reduce hospitalizations.

You will collaborate with an interdisciplinary care team, navigate insurance benefits with the Patient Relations Manager, and provide both longitudinal and episodic care coordination while documenting

Qualifications

• MSW degree from a CSWE-accredited program.
• Licensed in the state where OSH Center is located.
• Fluency in Spanish, Polish, Russian, or other community languages as needed.
• Proficient computer skills (Microsoft, GSuite, EMR).
• US work authorization.

Responsibilities

• Provide comprehensive assessments and advocacy for high-risk patients and caregivers.
• Coordinate care with interdisciplinary teams to improve health outcomes.
• Navigate insurance benefits in collaboration with the PRM to maximize plan benefits.
• Document interventions timely for care-team visibility.
• Educate patients on supportive care options and goals of care.

Skills

MSW degree required

State licensure

Multilingual (Spanish/Polish/Russian)

EMR proficiency

US work authorization

Education

Master of Social Work degree (CSWE-accredited)

Job description

Oak Street Health is seeking a Medical Social Worker to support psychosocial needs of patients within Oak Street Health Centers. The role includes assessments, advocacy, and care coordination for high-risk patients and their caregivers to improve health status and reduce hospitalizations.

You will collaborate with an interdisciplinary care team, navigate insurance benefits with the Patient Relations Manager, and provide both longitudinal and episodic care coordination while documenting