Social Worker MSW

Innovative Integrated Health Inc; Fresno (CA); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Employee assistance program

Flexible spending account

Health insurance

Health savings account

Life insurance

Paid sick time

Paid time off

Referral program

Retirement plan

Vision insurance

Job summary

Innovative Integrated Health Inc is seeking a Social Worker MSW to join PACE by IIH's interdisciplinary team delivering care to frail elderly in a community-based setting in California.

You will conduct assessments, provide counseling, coordinate discharge planning, and advocate with agencies while maintaining records and participating in IDT meetings.

Qualifications

• Master’s degree in social work from an accredited school of social work.
• Minimum of one year of experience with the frail or elderly population.
• Preferred experience in community-based or geriatric programs.
• Knowledge of psychosocial, behavioral, and family needs of the elderly.

Responsibilities

• Participate as a member of the interdisciplinary team (IDT) and conduct assessments.
• Provide individual and family counseling, crisis intervention, and advocacy as needed.
• Coordinate discharge planning and family meetings for participants.
• Maintain case management records and ongoing documentation of services.
• Act as liaison with aging services, Social Security, Medicaid, and other agencies.

Skills

Interdisciplinary team working

Assessment skills

Counseling skills

Crisis intervention

Oral and written communication

Documentation/computer skills

Knowledge of aging services

Advocacy with agencies

Education

MSW (Master of Social Work)

Job description

Who We ArePACE by IIH is empowering senior participants to age at home with dignity through personalized, comprehensive care plans that deliver high-quality health and human services along with strong community support. Through an interdisciplinary and participant-centered model of care, PACE by IIH is committed to improving quality of life, promoting independence, and providing compassionate support tailored to the unique needs of each participant. Our team works collaboratively to deliver innovative, community-based healthcare solutions that allow seniors to remain safely and comfortably in their homes while receiving the care and services they need to thrive.Benefits401(k)Dental insuranceEmployee assistance programEmployee discountFlexible spending accountHealth insuranceHealth savings accountLife insurancePaid sick timePaid time offReferral programRetirement planVision insuranceJob SummaryThe Social Worker MSW is responsible for direct social work case management services to participants and works collaboratively with the PACE Interdisciplinary Team (IDT) to manage long-term care needs.Essential Job FunctionsDuties include, but not limited to:Participate as a member of the interdisciplinary team (IDT), conduct initial, semi-annual, unscheduled, and annual assessments; attend morning updates and report changes in participants’ baseline status to appropriate staff on a daily basis.Familiar with the California Adult Protective Services (APS) mandated reporting requirements and guidelines.Provide education regarding Durable Power of Attorney, Advance Health Care DirectiveDeliver psychoeducation regarding depression, assessment, and cognitive assessment results to participants and their family members.Involved in the development and implementation of Quality Improvement (QI) activities.In conjunction with the interdisciplinary team (IDT), may conduct the initial intake, meeting with family members and others. Coordinate ongoing family meetings, as needed.Obtain biopsychosocial history from participant and/or family members upon admission to the program.Provide individual and family counseling as needed or prescribed in the plan of care; develop and lead group counseling and support activities.Provide crisis intervention and advocacy as required.In conjunction with the IDT, coordinate discharge planning for participants returning home from hospital or nursing facility.Maintain current, written case management records, including ongoing documentation of services provided, reassessment of changing needs and participant’s expressed wishes.Act as liaison between the participant and other agencies such as Department of Aging, Social Security Administration, Medicaid, etc.May be required to use personal vehicle, if applicable. If using a personal vehicle, a valid California Driver’s License is required.Provide resources and referrals to assist with financial management.Assist with ongoing financial eligibility for participants, including recertification as needed.Participate in participant-related conferences in the community as designated.Maintain confidentiality of participant information.Attend and participate in staff meetings, in-services, projects, and committees assigned.Adhere to and support the company’s practices, procedures, and policies including assigned break times and attendance.Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.Be flexible in the schedule of hours worked.Knowledge, Skills, and AbilitiesInterest in the risk-based long-term care program to serve frail elderly in a community-based setting.Experience and thorough knowledge of social service principles and practices.Knowledge of psychosocial, behavioral, and family needs of the elderly population.Knowledge of the local and social service delivery systems and aging network.Proven ability to work in an interdisciplinary team.Ability to work effectively and harmoniously with the staff, the elderly, and providers of services, public, and private agencies.Energetic, dependable, resourceful, and flexible.Effective oral and written communication skills.Computer skills required.Working Conditions and Physical DemandsThe working conditions and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Ability to access all areas of the center throughout the workday.Ability to lift up to 35 pounds occasionally, 15 pounds frequently, and 7 pounds constantly; required to obtain assistance of another qualified employee when attempting to lift or transfer objects over 25 pounds.Requires constant hand grasp and finger dexterity; frequent sitting, standing, walking and repetitive leg and arm movements, occasional bending, reaching forward and overhead; squatting and kneeling.Ability to communicate verbally with an excellent comprehension of the English language.Work is generally performed in an indoor, well-lit, well-ventilated, heated, and air-conditioned environment.ExperienceMinimum of one (1) year of documented experience in working with the frail or elderly population.Preferred experience in a community-based setting or geriatric program.Preferred experience in substance abuse counseling.Preferred experience in working with the homeless population.Education and CertificationMaster’s degree in social work from an accredited school of social work.Is medically cleared for communicable diseases and has all immunizations up to date before engaging in direct participant contact.Core ValuesCARE is central to what we do, prioritizing the well-being, dignity, and independence of our senior participants.COMPASSION in every interaction, ensuring kindness, empathy, and understanding guide our care.CULTURE that reflects the diverse backgrounds of those we serve and fosters a workplace where every team member feels supported, valued, and empowered to grow.COMMUNITY that fosters connection, belonging, and support for participants and their families.COMMITMENT to quality improvement, innovation, and delivering healthier outcomes.We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.