About the job Home Health Social Worker Care Manager
Overview
Social Workers are needed for a dynamic, fast-paced start-up with an innovative care management position that is transforming the delivery of kidney care. You will be driving to patients' homes who suffer from chronic kidney disease. We are looking for someone who works well with ambiguity, drive time, and telehealth components. Most patients are suffering from chronic kidney disease (CKD) and end-stage renal disease (ESRD).
Requirements:
Work Monday to Friday 8:00 am to 5:00 pm and occasionally after 5:00 pm
You must be mission-driving and willing to deal with underserved populations
Master's Degree in Social Work, behavioral sciences, or another related field
Currently licensed as an LCSW or LMSW
2+ years of experience working in care management and/or with chronic illness 2+ years of experience working in medical settings such as home health, dialysis, or hospice
Tele-health! Ability to take calls remotely on some nights and weekends
Self-starter with the ability to work independently with minimal supervision
Must show empathy and quickly build relationships with patients and CBOs
Excellent verbal communication skills both in person and on the phone
Must be fully vaccinated
Must be willing to travel to the patient's home
Perks:
Competitive compensation, of $65,000
Flexible paid leave (PTO), sick days, and vacation policy
Full Benefits (Medical, Dental, & Vision)
401K Plan
Laptop & Phone Allowance (if applicable details will be discussed)
Internal Growth Opportunities
Job Descriptions:
Lots of driving! This position will cover a two-hour travel radius.
Rare domestic travel may be required to headquarters in Nashville, TN
Ability to occasionally visit patients or take calls remotely on some nights and weekends
Work with Microsoft Office and mobile phone and web-based applications
Perform in-home care management visits to assess and impact their social and behavioral status
Work closely with Care Team to ensure continual progress on all care management goals
Assess social determinants of health needs and develop a plan for addressing them
Perform behavioral, environmental, and social support assessments and surveys
Deliver individual, family, and group education on living with chronic illness
Engage family and social support groups in the education and care of patients
Assess patients and refer them to behavioral health specialists for diagnosis and treatment Help patients to understand accept and follow medical and lifestyle recommendations
Serve as the point of contact for patient questions regarding social and behavioral
Facilitate conversations around and consideration of proactive care decisions, especially relating to transplantation, home modalities, and AV fistula placement
Initiate patient relationships through enrollment and onboarding processes
Document patient updates and progress in the EMR
Identify, vet, and build relationships with local Community-Based Organizations
Introduce patients to appropriate resources and act as the patient advocate
Serve as subject matter expert on social determinants for other members of the Care Team
Interview Process:
Brief screening call with a talent advisor
Phone Interview with HR
Video Zoom interview the operations manager and leadership