Social Services Coordinator

Cascadia EE LLC; Tigard (OR); On-site; USD 60,000 - 75,000; Full time

Job summary

Cascadia Healthcare is seeking a Social Services Coordinator to advocate for residents and protect their best interests in a post-acute setting. The role emphasizes psychosocial assessment, person-centered planning, and coordinating community resources.

Expected duties include discharge planning, collaboration with the care team, and ensuring documentation accuracy to support resident wellbeing and smooth transitions post-discharge.

Qualifications

• Bachelor’s or Master’s degree in social work.
• Must hold LCSW, LSW, or MSW license.

Responsibilities

• Assesses psychosocial status of patients and communicates findings to the nurse.
• Carries out social evaluations and plans person-centered interventions.
• Maintains clinical documentation for all patients referred to social work.
• Provides information and coordinates referral services for residents and families regarding practical and environmental needs.
• Provides information to residents or families regarding community agencies and other available services.
• Serves as liaison between residents and community agencies.
• Participates in developing the total plan of care and case conferences for residents referred to social services.
• Assists physician and team in understanding social and emotional factors related to health problems.
• Coordinates discharge planning and post-discharge practical/environmental needs.

Skills

Communication skills

Education

Bachelor’s or Master’s degree in social work

Job description

Description

The responsibility of the Social Services Coordinator is to act as an advocate for the residents. The Social Services Coordinator protects vulnerable residents and ensure that their best interest is observed an helps them to find remedies to their situation.

Note: All employees of Cascadia Healthcare are required to submit and be cleared to work in the facility per each state's specific background check requirements prior to contact with patients/residents.

Essential Functions

• Assesses the psychosocial status of patients related to the patient’s illness and environment and communicates findings to the registered nurse.
• Carries out social evaluations and plans person-centered intervention based on evaluation findings.
• Maintains clinical documentation on all patients referred to social work.
• Provides information and coordinates referral services for residents/patients and families/caregivers regarding resident’s/patient’s practical and environmental needs.
• Provides information to residents/patients or families/caregivers regarding community agencies and other available services.
• Serves as liaison between residents/patients or families/caregivers and community agencies.
• Maintains collaborative relationships with facility co-workers to support resident/patient care.
• Participates in the development of the total plan of care and case conferences for residents/patients referred to social services, as required.
• Assists physician and other team members in understanding significant social and emotional factors related to residents’/patients’ health problems.
• Establishes behavior monitoring and interventions to provide quality care to resident and reduce/alleviate necessity of medication use.
• Addresses resident behaviors to prevent harm to themselves or others.
• Actively participates in discharge planning and advises on issues relating to resident’s/patient’s practical and enviro mental needs post-discharge.
• Coordinates medication review regimen to determine gradual dose reduction to the lowest possible dose.

Knowledge/Skills/Abilities

• Demonstrates good verbal and written communication, and organization skills.

Requirements

Education

• Bachelor’s or Master’s degree in social work.

Licenses/Certification

• LCSW, LSW, or MSW license required.
• Must have a valid driver’s license.

Experience

• Experience in post-acute/ skilled nursing preferred.