Medical Social Worker

Oak Street Health; Philadelphia (Philadelphia County); On-site; USD 60,000 - 75,000; Full time

Job summary

Join a leading health solutions company as a Medical Social Worker. This role involves supporting patients' psychosocial needs, providing assessments, and coordinating care. Collaborate with care teams to improve health outcomes and empower patients. Ideal candidates will have a Master of Social Work degree and experience in healthcare settings.

Qualifications

• Master's degree required from an accredited school of social work.
• Minimally licensed in the state where OSH Center is located.
• Minimum one year of medical social work experience preferred.

Responsibilities

• Provide comprehensive assessments and care coordination for high-need patients.
• Educate patients on supportive care options and goals of care counseling.
• Respond to crises and urgent needs while prioritizing work.

Skills

Fluency in Spanish

Fluency in Polish

Fluency in Russian

Proficient computer skills

Problem-solving orientation

Education

Master of Social Work degree

Tools

Microsoft

GSuite

Electronic medical records

Job description

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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels, and more than 300,000 purpose-driven colleagues – caring for people where, when, and how they choose in a way that is uniquely more connected, more convenient, and more compassionate. And we do it all with heart, each and every day.

The Medical Social Worker is a key member of Oak Street Health Centers, contributing a unique and valuable perspective to care teams to support the psychosocial needs of our patients. In collaboration with the interdisciplinary care team, they will provide assessments, advocacy, and comprehensive care coordination services to our highest-risk patients and their caregivers to help them improve their health status and avoid hospitalizations.

Core Responsibilities

1. Proactively support our highest-need patients by providing comprehensive assessments, telephonic check-ins, and in-person visits.
2. Partner with the patient and their support persons (if necessary) to identify goals, increase engagement in their healthcare, address barriers, and drive the execution of their care plan.
3. Maintain extensive knowledge of community resources and make referrals, as appropriate, to help ensure the patient's healthcare and psychosocial needs are met.
4. Navigate patient insurance benefits in collaboration with the Patient Relations Manager (PRM) to ensure mindful utilization and maximization of plan benefits.
5. Provide both longitudinal and episodic comprehensive care coordination with the ultimate goal of empowering patients to independently manage their health conditions and have increased quality of life.
6. Educate patients on supportive care options (including advance care planning and end-of-life care) and provide goals of care counseling, support, and advocacy at all stages of the patient journey.
7. Provide psychoeducation to patients and families surrounding life stage and disease-specific issues, including dementia, adjustment to illness, aging, caregiver support, etc.
8. Meet with care teams to collaborate and generate creative solutions to patient issues, and spearhead intervention in situations with complex psychosocial dynamics.
9. Complete concise and comprehensive documentation on time to ensure that all care team members have visibility into the status of MSW interventions.
10. Partner with Community Health Workers and provide clinical guidance and consultation regarding complex patient needs to these team members.
11. Respond to crises and urgent needs with the keen ability to prioritize work, triage situations, and multitask.
12. Other duties as assigned.

This role reports to the Practice Manager.

Required Qualifications

• Master of Social Work degree required from a school of social work accredited by the Council on Social Work Education (CSWE).
• Minimally licensed in the state where OSH Center is located.
• Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve (where necessary).
• Proficient computer skills (including Microsoft, GSuite, and electronic medical records).
• US work authorization.

Strongly Preferred Qualifications

• Prior experience with complex care coordination and/or population healthcare management.
• Familiarity with using metrics and data to guide practice and drive outcomes.
• Minimum one year of medical social work experience in a healthcare environment, preferably within the last two years.

Other Skills

• Motivated, experienced social workers with a problem-solving orientation and a flexible and positive attitude who are driven to improve the lives of the individuals that OSH serves.
• Passion for working with Medicare-eligible populations, including older adults, adults with disabilities, and adults with severe and persistent mental illness.
• Embodies being 'Oaky' — radiating positive energy, assuming good intentions, creating an unmatched patient experience, driving clinical excellence, taking ownership and delivering results, and being relentlessly determined.

Why Oak Street Health?...