Social Worker MSW

TEEMA Group; San Jose (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

TEEMA Group is seeking a dedicated Social Worker to deliver psychosocial assessments, care coordination, counseling, and referrals to community resources under supervision. The role focuses on empowering patients and families to maintain independence and improve quality of life.

The position emphasizes teamwork, compassion, and a direct impact on patient well‑being, with responsibilities including home visits and community engagement as part of clinical practice and case management.

Qualifications

• MSW from an accredited institution is required.
• Bachelor’s degree in Social Work may be considered with relevant experience and language proficiency.
• Minimum of one (1) year of experience working with frail or elderly populations.

Responsibilities

• Provide psychosocial assessments and individualized care plans.
• Coordinate with caregivers, family, and support systems to deliver coordinated care.
• Offer individual counseling to patients as needed.
• Engage with community resources and services to support patient well‑being.
• Discharge planning and transition coordination when leaving the program.

Education

Master’s degree in Social Work (MSW)

Bachelor’s degree in Social Work

Tools

Microsoft Office

Electronic Health Record (EHR) systems

Job description

The Social Worker provides compassionate and comprehensive case management services to patients, empowering them and their families to maintain independence and enhance quality of life. Working under the supervision of the Regional Social Work Manager, with guidance from the Center Director and support from the Social Work Lead, this role is an essential part of the team. The Social Worker delivers psychosocial assessments, care coordination, counseling, and referrals to community resources—ensuring patients receive the individualized support they need to thrive.

This is an excellent opportunity for a motivated, empathetic, and organized professional who values teamwork, meaningful connections, and making a direct impact on people’s lives.

Duties and Responsibilities

Clinical Practice & Case Management

Exercise independent judgment to provide case management services for a panel of patients.

Conduct comprehensive initial and routine psychosocial assessments to develop, implement, and update individualized care plans.

Collaborate with caregivers and support systems to establish and deliver coordinated care plans.

Identify psychosocial risks, challenges, and service needs; advocate, refer, coordinate, and follow up on patient support in a timely manner.

Provide individual counseling to patients as needed.

Facilitate family conferences and patient/caregiver support groups.

Engage with the community to identify and access services that support patient well‑being.

Conduct discharge planning and coordination when a patient transitions out of the program.

Participate in special events such as caregiver workshops and educational sessions.

May review and verify assessments completed by other social work staff.

Serve as a primary liaison between patients, caregivers, the team, and community partners.

Collaborate with external agencies such as healthcare plans, community‑based organizations, and care facilities.

Adhere to ethical and legal standards of social work practice.

Comply with all organizational policies and procedures, including safety and confidentiality regulations.

Complete all documentation promptly and accurately.

Actively participate in team meetings, advocate for patient and caregiver needs, and contribute to collaborative care planning.

Support continuous improvement efforts to enhance service quality and operational efficiency.

Deliver 5-star service guided by compassion, respect, and professionalism.

Perform other related duties as assigned.

Required Qualifications

Master’s degree in Social Work (MSW) from an accredited institution is required.

A bachelor’s degree in Social Work may be considered with relevant experience and language proficiency.

Minimum of one (1) year of experience working with frail or elderly populations.

Licenses and Certifications

Valid Social Worker license in the state of California (MSW – Medical Social Worker).

Knowledge, Skills, and Abilities

Experience and ability to work effectively with diverse populations.

Skilled in collaborative teamwork and interdisciplinary care coordination.

Strong interpersonal skills with the ability to build trust and rapport with patients, caregivers, and colleagues.

Highly organized with the ability to prioritize, manage multiple tasks, and follow up thoroughly.

Excellent verbal and written communication skills.

Proficient in Microsoft Office and comfortable using electronic documentation systems.

Bilingual ability may be required for specific assignments.

Strong foundation in clinical practices and case management principles.

Desired Qualifications

One (1) year or more of post-MSW experience.

Prior experience in case management or healthcare settings.

Familiarity with electronic health record (EHR) systems.

Location and Work Type

Work Type: On-site, with responsibilities that may include visits to patient homes, community settings, and care facilities.