Social Services Coordinator

West PACE; San Marcos (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Gary and Mary West PACE in San Marcos, CA, seeks a Social Services MSW Coordinator to support the Social Services Department under the supervision of the Social Services Supervisor. You will coordinate MSW schedules for assessments, care planning, and participate in IDT meetings to ensure quality, person-centered care for frail elders.

Responsibilities include preparing for assessments, presenting care plans, maintaining records within 72 hours, and liaising with external agencies.

Qualifications

• Minimum one year experience with frail or elderly populations.
• Experience in behavioral health or social services setting.
• Excellent written and verbal communication skills.
• Ability to establish and maintain effective working relationships with participants, co-workers, vendors, medical staff, and the public.
• Proficiency in Microsoft Office applications; EMR experience preferred.

Responsibilities

• Participate as a supportive member of the interdisciplinary team (IDT) and track tasks for the Social Services Department.
• Attend IDT meetings and report status of tasks for coordination of social service activities.
• Coordinate and manage the MSW schedule for in-person assessments and care conferences.
• Prepare the MSW for assessments, conferences, and higher level of care meetings.
• Present care plans to participants and obtain signatures for the EMR.
• Maintain confidential case management records and document interactions within the required timeframe.
• Act as liaison between participants and agencies (e.g., Department of Aging, Social Security, Medicaid).
• Assist with obtaining statements of income and assets and participate in community conferences.

Skills

Geriatrics experience

Behavioral health

Excellent communication

Relationship building

MS Office proficiency

Education

High School Diploma or GED

CPR/Basic Life Support

California Driver's License

Tools

EMR systems

Job description

Position is located in San Marcos, CA.

Join the Team Voted Best Place to Work in North County!

Why Work for Gary and Mary West PACE?

Because you're looking for more than just a job - you want work/life balance and the opportunity to make a meaningful impact in the lives of North County seniors and their families.

At Gary and Mary West PACE, we support your personal and professional well-being with:

• Generous pay and a comprehensive benefits package focused on your health and wellness.
• 11 paid holidays, 13 days of PTO, and 5 days of sick time.
• A 5% employer match to our 403(b) retirement plan.
• No on-call time – because your time matters.

We invest in our team with an annual education allowance and a commitment to professional growth, helping you expand your skills and advance your career.

You’ll thrive in a supportive, mission-driven culture where collaboration feels like family. As part of our multi-disciplinary team, your voice is heard, and your work is truly valued.

Join us and do your best work-because here, your contribution matters.

About PACE

Philanthropists Gary and Mary West founded West Health with the mission of enabling seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life, and independence. The Gary and Mary West PACE (Program of All-inclusive Care for the Elderly), affiliated with West Health (www.westhealth.org), is a non-profit that delivers medical, social, and behavioral services to the frail elderly to the North County of San Diego. This PACE center is entrepreneurial in nature and focuses on innovations and bringing new processes to the traditional PACE environment.

We're looking for passionate healthcare providers who want to be part of a team dedicated to enable seniors to live in their communities as independently as possible by providing compassionate, comprehensive health and supportive care.

One Team One Mission

Position Summary:

Under the direction of the Social Services Supervisor, is responsible for coordinating and supporting all aspects of the Social Services Department.

Essential Functions:

• Participate as a supportive member of the interdisciplinary team (IDT), tracking all components and assigned tasks associated with the Social Services Department and assigned IDT MSW.
• Attend morning IDT meetings and report status of tasks and assignments pertaining to the coordination of social service activities for all assigned participants.
• Coordinate and manage the MSW schedule for in-person assessments including change of conditions, service delivery request/denial assessments, care conferences, and higher level of care assessments and committee meetings.
• Prepare the MSW for assessments, conferences, higher level of care meetings.
• Prepare the MSW for and attend care planning meetings with IDT.
• Present care plans to participants and obtain signatures to be uploaded to the electronic medical record.
• Administer psychometric scales as needed for the MSW – including PHQ-9 and GAD-7.
• Work closely with participants and families to establish and maintain exemplary rapport and ongoing relationships to provide the highest quality of care in a person-centered, trauma-informed manner.
• Coordinate ongoing family meetings, as needed.
• Monitor the individual interventions prescribed in the plan of care and update medical record regularly.
• Alert SW/BH staff of crises that arise in the day center or in the community.
• Maintain current, accurate, professionally written case management records submitted within 72 hours of all encounters pertaining to a participant's care. This includes ongoing documentation of all communication, services provided, participant expressed wishes, and statuses of all.
• Act as liaison between the participant and other agencies such as Department of Aging, Social Security Administration, Medicaid, etc.
• Alert the MSW to needed referrals to community or specialized programs when indicated.
• Assist with obtaining and maintaining current statements of income and other assets.
• Participate in participant-related conferences in the community as designated.
• Maintain confidentiality of participant information.
• Attend monthly meetings with supervisor.
• Attend bi-weekly mandatory department meetings.
• Attend and participate in all staff meetings, in-services, projects, and committees as assigned.
• Adhere to and support the center's policies, practices, and procedures.
• Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
• Be flexible in the schedule of hours worked.
• Will require use of personal vehicle.

Education and Certification:

• High School Diploma or GED.
• Current Basic Life Support and CPR certification required.
• Current California Driver's License with proof of auto insurance.

Skills and Experience:

• A minimum of one year of experience working with a frail or elderly population required.
• A minimum of one year of experience working in a behavioral health or social services setting.
• Must maintain excellent written and verbal communication skills and demonstrate the ability to interact clearly and effectively with both internal and external customers as needed for the position.
• Skilled in establishing and maintaining effective working relationships with participants, co-workers, vendors, medical staff, and the public.
• Must be able to demonstrate proficiency in Microsoft computer applications. Experience working with Electronic Medical Record system (EMR) preferred.
• Operates in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, Emergency procedures and other Standards prescribed in law or regulations.
• Desire to work in the helping field with an emphasis of the geriatric population.

Medical Clearance:

Employees must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.

Job offers are contingent upon a successful pre-employment drug screen, background check, and physical assessment.

Gary and Mary West PACE provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, pregnancy, military and veteran status, age, physical and mental disability, genetic characteristics, gender, gender identity, gender expression or sexual orientation or any other considerations made unlawful by applicable state or local laws.