Home Health Social Worker & Care Coordinator

Upperline Health, Inc.; Nashville (TN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision

401K

PTO

Job summary

Upperline Health, Inc. is seeking a Social Worker to provide supportive medical social services to patients and their families in the home.

You will assess psychosocial needs and collaborate with the medical team to develop care plans addressing health status, goals, and social determinants of health. Ideal candidates will have Medicare experience, compassion, strong attention to detail, and thrive in a collaborative environment.

Qualifications

• MSW required; accredited program.
• Minimum of 3 years social work experience.
• Healthcare experience serving chronically ill patients preferred.
• Telephonic case management or care coordination experience preferred.
• Strong customer-service orientation.
• Patient, compassionate and professional demeanor.
• Exceptional organizational skills and ability to multi-task.
• Self-starter with an entrepreneurial spirit and problem-solving skills.

Responsibilities

• Assess and provide intervention to address patient and family physical and psychosocial needs in collaboration with the interdisciplinary team.
• Coordinate with clinical team members, other physicians, and providers to ensure resources and transportation for patients and families.
• Identify and close gaps in patient care.
• Triage and escalate routine to emergent calls.
• Document assessments, care plans, and interventions.
• Provide counseling related to social determinants of health.
• Collaborate with field-based NPs and physicians on treatment plans for complex issues.
• Identify community resources and assist patients in accessing them.
• Participate in weekly interdisciplinary team meetings.
• Complete other related duties as deemed necessary.

Skills

Telephonic case management

Care coordination

Compassionate care

Attention to detail

Communication skills

Organizational skills

Entrepreneurial spirit

Education

Master's in Social Work

Tools

Word

Excel

Database management

Job description

Upperline Health, Inc. is seeking a Social Worker to provide supportive medical social services to patients and their families in the home.

You will assess psychosocial needs and collaborate with the medical team to develop care plans addressing health status, goals, and social determinants of health. Ideal candidates will have Medicare experience, compassion, strong attention to detail, and thrive in a collaborative environment.