Field-Based Social Worker Care Coordinator – DC Area

Society for Social Work and Research; Washington (District of Columbia); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Sign-on bonus

401k plan

Stock purchase plan

Job summary

Optum Home & Community Care in the greater Washington, DC area is seeking a field-based social worker to coordinate care for members in their homes or long-term facilities. You will assess needs, develop individualized care plans, and work with a multidisciplinary team to ensure seamless, person-centered care.

Requires a Master’s in social work and an active LICSW/LGSW in DC or ability to obtain within 90 days; 2+ years in relevant settings and EMR experience are preferred.

Qualifications

• Master's degree in social work or related field required.
• Active LICSW or LGSW in DC or ability to obtain within 90 days.
• 2+ years in long-term care, home health, hospice, public health or assisted living.
• 1+ years with Electronic Medical Records and 2+ years with MS Word/Excel/Outlook.

Responsibilities

• Assess, plan and implement individualized care management for members.
• Develop care plans and act as single point of contact across continuum.
• Communicate health information to stakeholders for coordinated care.
• Advocate for members and families to reflect needs.
• Identify interventions/resources to meet gaps (psychosocial, transport, LTSS).
• Document plan of care in appropriate EHR systems.
• Maintain engagement through empathy and rapport.
• Collaborate with multidisciplinary team to align goals.
• Provide ongoing support for advanced care planning.
• Reassess plans based on changes or goals achieved.

Skills

Field-based work readiness

Communication

Care planning

Education

Master's degree in social work or related clinical field

LICSW or LGSW license in DC or ability to obtain within 90 days

Certified Case Management (CCM)

Job description

Optum Home & Community Care in the greater Washington, DC area is seeking a field-based social worker to coordinate care for members in their homes or long-term facilities. You will assess needs, develop individualized care plans, and work with a multidisciplinary team to ensure seamless, person-centered care.

Requires a Master’s in social work and an active LICSW/LGSW in DC or ability to obtain within 90 days; 2+ years in relevant settings and EMR experience are preferred.