PRN Renal Social Worker

Naswtx; Laredo (TX); On-site; USD 39,000 - 63,000; Full time

Job summary

Concerto Renal Services is seeking a PRN Social Worker to provide psychosocial assessments, counseling, and quality-of-life support to dialysis patients in Skilled Nursing or rehab facilities.

You will collaborate with an interdisciplinary team, document in EMR, and support timely care planning per CMS guidelines while maintaining detailed records to meet Concerto policies.

Responsibilities

• Patient assessments and care planning with interdisciplinary team.
• Counseling and education on dialysis, transplant options, and advance directives; supports treatment adherence.
• Leads monthly care plan meetings with patients and clinical staff; coordinates with facility teams and managers.
• Maintains EMR documentation; tracks productivity; ensures CMS guidelines compliance.
• Advocacy and resource coordination, discharge planning, and connection to community resources.

Job description

Why Work at Concerto? What is in it for you?

• Clinical/Corporate Career Advancement
• Flexible Schedule
• Minimum of two (2) monthly shift pick ups

Who Are We?

Concerto Renal Services is an industry leader in sub-acute hemodialysis within a skilled nursing facility and/or long-term care facility. We are a rapidly expanding business with a simple mission: reimagining dialysis care, one community at a time. Our model focuses on ensuring those with end-stage renal disease receive the best possible care through a more convenient, centralized, continuous care model.

Why is this Role Essential?

Concerto is seeking a PRN Social Worker to join its team! This role provides psychosocial evaluations, counseling, and quality-of-life support to dialysis patients in Skilled Nursing or rehab facilities. As part of the interdisciplinary team, the PRN Social Worker addresses psychosocial needs, ensures timely care planning per CMS guidelines, and maintains detailed documentation to meet QAPI standards. The position reports to the market Team Lead and indirectly to the Director of Social Services.

What Will You Do?

1. Patient Assessment & Care Planning
   Conducts psychosocial assessments (initial, 90-day, annual, and as-needed), administers quality-of-life and depression screenings (KDQOL, PHQ-2/9), and develops individualized care plans in collaboration with the interdisciplinary team.
2. Therapeutic Support & Education
   Provides counseling and education on dialysis, transplant options, and advance directives; delivers interventions to support treatment compliance and quality of life; and develops patient education materials.
3. Interdisciplinary Collaboration
   Leads monthly care plan meetings with patients and clinical staff, coordinates with facility teams, EQRS specialists, and regional managers, and supports new clinic openings and admissions.
4. Documentation & Compliance

Maintains accurate EMR documentation of assessments, interventions, and follow-ups; tracks and reports productivity and outcomes; and ensures compliance with CMS guidelines and Concerto policies.

1. Advocacy & Resource Coordination
   Addresses patient and family concerns, assists with outpatient dialysis placement and discharge planning, and connects patients with community resources while supporting grievance reporting.