Home-Based Social Worker: Care Coordination & Support

Upperline Health Inc; Nashville (TN); Sur place; USD 55 000 - 75 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision

401K

PTO

Résumé du poste

Upperline Health Inc. is seeking a Social Worker to provide in-home social work services and coordinate patient transitions from facility to home. You will conduct psychosocial assessments, collaborate with the care team, and identify community resources to support patients and families.

The role emphasizes compassion, attention to detail, and teamwork within a fast-growing care model. Experience with Medicare patients is preferred and a strong customer-service orientation is essential.

Qualifications

• MSW from an accredited institution is required.
• Minimum of 3 years social work experience.
• Telephonic case management or care coordination preferred.
• Strong customer-service orientation.
• Patient, compassionate and professional demeanor.
• Excellent organizational skills and ability to multi-task.
• Self-starter with problem-solving skills.
• Experience in a fast-growing, changing environment.

Responsabilités

• Assess and intervene to address patient and family physical and psychosocial needs with the interdisciplinary team.
• Coordinate care with other clinicians, including transportation and financial counseling.
• Identify and close care gaps, triage calls, and document assessments and plans.
• Provide brief counseling for psychosocial issues related to social determinants of health.
• Collaborate with NPs and physicians to implement treatment plans.
• Identify community resources and help patients access them.
• Complete clinical and administrative tasks and participate in weekly team meetings.

Connaissances

Communication skills

Customer service

Organizational skills

Problem solving

Self-starter

Team collaboration

Documentation

Formation

MSW

Outils

MS Word

Excel

Database management

Description du poste

Upperline Health Inc. is seeking a Social Worker to provide in-home social work services and coordinate patient transitions from facility to home. You will conduct psychosocial assessments, collaborate with the care team, and identify community resources to support patients and families.

The role emphasizes compassion, attention to detail, and teamwork within a fast-growing care model. Experience with Medicare patients is preferred and a strong customer-service orientation is essential.