Social Worker

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

ABOUT US

A Specialty Path to Good Health

Upperline Health is the nation's largest provider group dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of transforming specialty care, Upperline Health is a pioneer in bringing value-based care models into specialty care. Upperline delivers a more efficient path for patients to receive consistent and effective treatment for chronic illnesses.

Triage is temporary.

Treatment is transformative.

Upperline Health providers coordinate patients' care among a team of specialists -- physicians, advanced practice providers, care navigators, pharmacists, dieticians, and social workers for integrated treatment that addresses patients' immediate and long-term health needs.

We put patients at the center of value-based care.

About the Social Worker

Upperline Health is seeking a Social Worker who will be responsible for providing supportive and medical social services to patients and their families in the home. This will include a range of tasks such as directly providing support to Upperline's patients and families in the home as well as coordinating patient transition from facility to the home. The Social Worker assists the medical team in completing comprehensive psycho-social assessment to identify issues related to social determinates of health and collaborate in care plan development as a vital part of the interdisciplinary team to address individual patient's unique psychosocial needs, health status, and overall goals and values.

Ideal candidates will have experience working with Medicare patients. Most importantly, candidates must demonstrate compassion for patient needs, have great attention to detail and thrive in a collaborative environment.

What You'll Do

• Assess and provide intervention to address patient and family physical and psychosocial needs in collaboration with the interdisciplinary team
• Communicate with other Upperline clinical team members, patient's other physicians and patient's other medical providers to coordinate optimal care and resources for the patient and his or her family, including social support and transportation needs, financial counseling, identifying non-clinical community resources, mitigating family dynamics and patient compliance issues, and assisting patients in logistically accessing available healthcare services
• Assess, identify and close clinical and non-clinical gaps in patient care
• Appropriately triage and elevate routine, urgent and emergent patient calls
• Document social work assessments, care plans, and interventions
• Provide brief, targeted counseling and intervention for psychosocial, emotional issues related to social determinants of health
• Collaborate with field-based NPs and physicians to develop and implement effective treatment plans and interventions for complex patient care issues
• Identify community resources and assist Upperline's patients and families in accessing those resources
• Complete various clinical and administrative tasksParticipate in weekly interdisciplinary team meetings
• Complete other related duties as deemed necessary by Upperline Health

Qualifications of the Social Worker

• Master's degree in social work from an accredited institution is required
• Minimum of 3 years social work experience required, preferably in a centralized care management team environment
• Prior healthcare experience serving chronically ill patients living with limited resources, serious emotional disturbance, and/or mental illness preferred
• Telephonic case management or care coordination experience preferred
• Strong customer-service orientation
• Patient, compassionate and professional demeanor required
• Exceptional organizational skills and ability to multi-task
• Self-starter with an entrepreneurial spirit and demonstrated problem-solving skills
• Strong writing, Word, Excel, and database management skills
• Extremely strong work ethic
• Experience working in a fast-growing, rapidly changing environment

Benefits

Comprehensive benefit options include medical, dental and vision, 401K and PTO.

Compensation

Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience