Social Worker Care Advocate, Full Time Days

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Relocation assistance

Job summary

Cape Fear Valley Health System in Fayetteville, NC, seeks a Care Advocate to support pregnant and postpartum patients from enrollment through 12 months postpartum. The role emphasizes empathetic engagement, care planning, and collaborative decision-making with OB, pediatrics, and community partners.

Responsibilities include screening, brief interventions, risk triage, and strong documentation in the EHR. Must hold a MSW and NC license; two years in care coordination and behavioral health are

Qualifications

• Masters degree in social work or equivalent required.
• Licensed Clinical Social Worker in North Carolina required.
• Experience in care coordination or patient navigation preferred.

Responsibilities

• Review screening results and relevant EHR information daily.
• Conduct phone or video assessments for positive screens (mental health, substance use, IPV, SDoH).
• Deliver brief interventions and collaborative care plans using motivational interviewing.
• Triage and manage risks; escalate medical or behavioral health emergencies per SOPs.
• Complete warm handoffs; schedule with internal/external providers; ensure privacy-conscious information exchange.

Skills

Communication skills

Bilingual English/Spanish (preferred)

Care coordination

Motivational interviewing

EHR documentation

Education

Master's degree in social work

Licensed Clinical Social Worker (NC)

Tools

EHR software

Job description

Relocation Assistance Available!! Facility Cape Fear Valley Medical Center Location Fayetteville, North Carolina Department Women & Children Administration Job Family Professional Work Shift Days (United States of America)

Summary The Care Advocate serves as the trusted point of contact for pregnant and postpartum patients from enrollment through 12 months postpartum. The role combines empathetic engagement, structured brief assessment/intervention, care planning with shared decision-making, motivational interviewing techniques, closed-loop referrals, and consistent communication with OB, pediatrics, primary care, behavioral health, and community partners. The Care Advocate documents all contacts, follows site safety protocols, and contributes to quality improvement and evaluation.

MAJOR JOB FUNCTIONS

• Review automated screening results and relevant EHR information daily.
• Conduct phone or video assessments for positive screens (mental health, substance use, IPV, SDoH, high-risk conditions).
• Deliver brief interventions (SBIRT principles), education, and collaborative care plans using motivational interviewing and shared decision-making.
• Triage and manage risks; elevate medical concerns to nursing/APRN partners and behavioral health emergencies per SOPs (suicide, overdose, psychiatric crisis, IPV danger).
• Complete warm handoffs; schedule with internal/external providers; ensure information exchange consistent with privacy laws and consents.
• Confirm engagement with referrals; troubleshoot barriers (transport, childcare, cost, coverage, language, etc.); re-engage as needed.
• Document assessments, plans, and follow-ups in the program platform and per site EHR standards (progress notes, messages).
• Communicate promptly with clinical teams about risks, plans, and updates; use closed-loop processes.
• Maintain accurate, timely logs and dashboards for fidelity and performance monitoring.
• Contribute to building and updating the site resource library; tailor resource lists to geography and patient preferences.
• Collaborate with the Patient Engagement Lead and community partners to strengthen pathways and reduce handoff failures.
• Other duties as assigned.

MINIMUM QUALIFICATIONS

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

EDUCATION AND FORMAL TRAINING:

• Masters degree in social work required
• Licensed Clinical Social Worker in North Carolina required

WORK EXPERIENCE:

• 2 years in care coordination/case management or patient navigation required
• 2 years of experience in behavioral health management required
• 1 year of experience conducting mental health/SUD risk assessments, brief interventions and referrals required
• 1 year of experience in obstetrics or maternal health preferred

KNOWLEDGE, SKILLS, AND ABILITIES:

• Proficiency in reading, writing and speaking the English language
• Bilingual (English/Spanish) preferred
• Knowledge of community resources and patient advocacy; experience with diverse populations and equity-focused, trauma-informed care.
• Proficiency with technology-enabled communication (texting platforms, telehealth) and accurate documentation
• Excellent interpersonal communication and negotiation skills
• Ability to communicate effectively and work with people of all social, economic and cultural backgrounds
• Proven written, telephonic and electronic communication skills
• Assertive and persuasive interactions with customers, peers, management and core staff served
• Strong organizational and time management skills
• Flexible, open-minded and adaptable to change

PHYSICAL REQUIREMENTS:

Light carrying and lifting may be required Walking may be required to access all areas of the Medical Center Ability to effectively communicate orally to patients, family members, personnel and physicians Visual acuity to proofread hand or typewritten materials Required Licenses and Certifications

Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity

For exceptional healthcare come to Cape Fear Valley Health where caring employees are committed to integrity, patient-centeredness and excellence throughout the entire healthcare process. At Cape Fear Valley Health, our goal is to improve the quality of every life we touch. Our diverse team of doctors, nurses and staff work together to create a better experience for every patient, every time. Cape Fear Valley is a 950-bed, 8-hospital regional health system, the 8th largest in North Carolina, with more than 1 million inpatient and outpatients annually. A private not-for-profit organization with over 7,000 employees and 850 physicians. Our employees and physicians proudly serve a seven-county region of southeastern North Carolina, including Fayetteville, Fort Bragg, Hope Mills, Raeford, Lumberton, Elizabethtown, Clinton, Lillington, Dunn and beyond. Our medical facilities include Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Cape Fear Valley Rehabilitation Center, Behavioral Health Care, Bladen County Hospital, Hoke Hospital, Central Harnett Hospital, Betsy Johnson Hospital, as well as more than 60 medical offices and specialty care clinics spread throughout the Cape Fear region.