Clinical Social Worker: Care Planning, Discharge & Advocacy

AHMC Healthcare Inc.; Daly City (CA); Presencial; USD 65.000 - 105.000; Jornada completa

Descripción de la vacante

AHMC Healthcare Inc. Social Worker position focuses on psychosocial support for residents, guiding care planning and discharge coordination. You will collaborate with the interdisciplinary team, families, and community partners to ensure ethical, patient-centered care in line with regulations.

The role emphasizes assessment, advocacy, documentation, and compliance with federal/state standards, HIPAA, and CMS conditions of participation, while supporting advance care planning and resident rights.

Formación

• Minimum 1 year of experience in social services and discharge planning.
• Strong knowledge of CMS Conditions of Participation, CDPH standards, and Title 22 requirements.
• Proficient in Google Docs; EMR/PCC experience preferred.
• Excellent verbal, written, and interpersonal communication; strong judgement.
• Demonstrated leadership, organization, teamwork, and problem-solving abilities.
• Ability to work effectively in a multidisciplinary, fast-paced environment and maintain composure under stress.

Responsabilidades

• Resident Assessment & Care Planning: Complete social service assessments and contribute to individualized care plans, ensuring goals support residents’ emotional, mental, and psychosocial needs.
• Admissions & Discharge Support: Assist with preadmission evaluations and required screenings; coordinate discharge planning including community services and follow-up care.
• Resident Advocacy & Support: Identify and communicate residents’ social, emotional, and psychological needs to the care team; advocate for residents’ rights and dignity.
• Documentation & Compliance: Maintain timely, accurate, complete documentation; ensure compliance with federal/state regulations, HIPAA, Title 22, CMS conditions of participation.
• Advance Care Planning: Support residents and representatives in understanding and completing Advance Directives; ensure staff are aware of code status and end-of-life preferences.
• Safety, Confidentiality & Reporting: Protect resident privacy, follow infection control and safety procedures, report incidents per guidelines.
• Resident Engagement & Daily Support: Obtain social histories, assist residents with personal needs, support communication, and act as a resource for behavioral interventions.
• Interdepartmental Collaboration: Coordinate Social Services with other departments and participate in care plan meetings and audits.
• Professional Development & Leadership: Complete required training, assist with policy development, and support leadership of the Social Services Department.

Conocimientos

CMS Conditions of Participation know–

CDPH standards knowledge

Title 22 requirements knowledge

Google Docs proficiency

EMR/PCC system experience

Verbal and written communication

Interpersonal communication

Leadership and organization

Teamwork and problem-solving

Herramientas

EMR/PCC system

Google Docs

Descripción del empleo

AHMC Healthcare Inc. Social Worker position focuses on psychosocial support for residents, guiding care planning and discharge coordination. You will collaborate with the interdisciplinary team, families, and community partners to ensure ethical, patient-centered care in line with regulations.

The role emphasizes assessment, advocacy, documentation, and compliance with federal/state standards, HIPAA, and CMS conditions of participation, while supporting advance care planning and resident rights.