Geriatric Social Worker: Care Coordination & CBT

PACE Southeast Michigan; Eastpointe (MI); On-site; USD 52,000 - 76,000; Full time

Job summary

Pace Southeast Michigan is seeking a Master’s Social Worker to assess, coordinate, and deliver social services for participants and families. The MSW participates in the IDT, develops treatment plans, and uses bio-psychosocial assessments and CBT techniques as part of care planning.

Responsibilities include case management, discharge planning, documentation in the EHR, and advocacy to support participant safety, housing, and care needs. Collaboration with the care team is essential.

Qualifications

• Master’s in Social Work (MSW) from an accredited school.
• Licensed to practice in Michigan (Limited license may be considered).
• One year of clinical social work experience, preferably in geriatrics.
• Knowledge of case management and patient-centered care.
• Ability to evaluate, plan, implement and monitor care.
• Knowledge of laws and regulations; culturally competent.
• Proficient with an EHR system.
• Proficient in Word, Excel, Outlook, PowerPoint.
• Positive, flexible and team-focused attitude.

Responsibilities

• Performs comprehensive bio-psychosocial assessments at enrollment and 180-day intervals.
• Develops and implements treatment plans with counseling, education and care coordination.
• Manages housing, financial, safety, psychiatric, and caregiver issues; discharge planning.
• Educates and counsels participants and caregivers on care needs.
• Advocates on behalf of participants and communicates with IDT.
• Collaborates to develop plans of care and documents progress in the EHR.
• Monitors outcomes and communicates progress to IDT and family.
• Performs other related duties as assigned.

Skills

Clinical social work

Geriatrics experience

Care coordination

Bio-psychosocial assessments

Cultural competence

Team collaboration

EHR documentation

Education

Master’s in Social Work (MSW)

Tools

EHR system

Microsoft Office

Job description

Pace Southeast Michigan is seeking a Master’s Social Worker to assess, coordinate, and deliver social services for participants and families. The MSW participates in the IDT, develops treatment plans, and uses bio-psychosocial assessments and CBT techniques as part of care planning.

Responsibilities include case management, discharge planning, documentation in the EHR, and advocacy to support participant safety, housing, and care needs. Collaboration with the care team is essential.