Complex Care Coordinator (LSW)

Public Health Management Corporation; Philadelphia (Philadelphia County); On-site; USD 45,000 - 55,000; Full time

Job summary

A leading organization in public health seeks a Complex Care Coordinator (LSW) to join their interdisciplinary team. This role involves providing community-based clinical social work and case management to diverse populations, ensuring timely access to health services and improving patient outcomes. Candidates must be licensed in Pennsylvania and possess a Master's in Social Work. Excellent communication and critical thinking skills are essential for success in this entry-level position.

Qualifications

• Licensed Social Worker required in Pennsylvania.
• Experience in behavioral medicine and health psychology.
• Knowledge of DSM 5 behavioral health conditions.

Responsibilities

• Provide multidisciplinary assessments to determine needs.
• Collaborate with healthcare providers on care plans.
• Engage clients to promote self-care and access services.

Skills

Clinical Judgment

Communication

Organizational Skills

Critical Thinking

Education

Masters Degree in Social Work

Licensed Social Worker

Job description

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PHMC is proud to be a leader in public health. PHMC requires that all employees are fully vaccinated with the Covid-19 vaccine before the first day of employment.

Mission Statement:

Our Mission is to be the premier regional provider of integrated, community-based healthcare by combining evidence-based clinical practices, outstanding patient service, innovative care partnerships, and team-driven excellence, within a healthy fiscal environment.

Position Overview:

Licensed Social Worker (LSW) sought to work as a part of an interdisciplinary complex care management team. The LSW will report to the RN Complex Care Manager and will be an integral part of the Specialized Health Services interdisciplinary team across the PHMC nurse-managed Health Network sites. The LSW will work at these health centers and in the community with diverse and underserved patient populations. The LSW will provide community-based clinical social work, case management, and outreach services to help coordinate care and improve patient health outcomes. This position provides clinical hours towards the LCSW. The LSW will receive clinical supervision from an LCSW from within the Health Network as well as training and support from the Health Network social services team.

Responsibilities:

1. Provide multidisciplinary assessments by evaluating all relevant information to determine needs and barriers in health care, social supports, and access to behavioral health services.
2. Actively participate as a member of the interdisciplinary health care team (IDT) by providing input and developing creative strategies to address health, behavioral health, and psychosocial issues.
3. Collaborate with medical and auxiliary providers in developing health care plans and goals based on identified needs.
4. Provide outreach and engage with clients by eliminating social, cultural, linguistic, and educational barriers to promote and encourage self-care.
5. Facilitate communication and positive relationship building between clients and medical providers.
6. Ensure that clients obtain timely and coordinated access to appropriate health and social services by promoting and modeling advocacy skills.
7. Provide individual counseling including:

• Functional and strength-based assessment and diagnosis.
• Psychoeducation for patients and their support systems.
• Medication adherence counseling and disease self-management counseling.
• Motivational Interviewing to develop behavioral strategies aimed at symptom reduction.
• Brief problem-solving cognitive interventions aimed at modifying negative thinking and promoting self-efficacy.
• Substance use/abuse evaluation, identification of maladaptive coping strategies, and development of harm reduction strategies.

Document all services in a timely manner in the electronic health record system.

Skills:

• Thorough knowledge of community resources.
• Knowledge of DSM 5 behavioral health conditions and working knowledge of chronic diseases.
• Ability to exercise strong clinical judgment, independent analysis, and critical thinking skills.
• Excellent time management skills and attention to detail to help develop sustainable programming, attend to caseload expectations, and ensure timely documentation.
• Strong interpersonal, organizational, and oral/written communication skills.

Experience:

• Medical literacy.
• Experience working in behavioral medicine and health psychology.
• Experience working as a member of an interdisciplinary team.
• Comfort with evidence-based interventions, including cognitive behavioral therapy, motivational interviewing, SBIRT.
• Experience with crisis intervention and substance abuse is highly desired.
• Comfort working with diverse populations (e.g., race, ethnicity, diagnoses, age ranges).

Education Requirements:

• Masters Degree in Social Work from an accredited school required.
• Licensed Social Worker (in Pennsylvania) required.

Physical Demands:

• Position requires standing/walking 2/3 of the time and sitting approximately 1/3 of the time. Use of hands 2/3 of the time. Reach with hands and arms under 1/3 of the time. Stoop, kneel, crouch, or crawl under 1/3 of the time. Talk or hear over 2/3 of the time. Position requires lifting up to 10 lbs. up to 1/3 of the time.

Work Environment:

• Moderate noise levels (examples: business office with computers and printers, light traffic). Exposure to blood-borne pathogens that requires the use of personal protective equipment.

Salary:

Commensurate with education and experience.

PHMC is an Equal Opportunity and E-Verify Employer.

Additional Details:

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Other
• Industries: Non-profit Organizations