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Social Worker - MSW - Albany

MedCentric

Social Worker - MSW - Albany

Albany, NY
Full Time
Paid
  • Responsibilities

    Who You Are

    You are devoted, compassionate, and enjoy being on the front lines in healthcare, changing the lives of your patients. Your passionate about getting to the root cause of a patient’s conditions, removing social determinants of healthcare, and ensuring the highest possible quality of life for those in your care. You don’t want to sacrifice quality over quantity, and you aim to provide the same level of care and commitment to your patients that you would to your own family member. Does this sound like you? If so, we should talk.

     

    Who We Are

    Our Client, a groundbreaking team of healthcare professionals focused on making a major impact in healthcare.  They  align every aspect of our health plans to support patients seeing our providers; we drive health improvements, create a seamless member experience, and eliminate duplicative costs. We listen to the needs of our patients and our employees, continually working to push beyond the status quo in which the care system manages patients today. For us, it’s all in an Honest day’s work.

     

    Your Role

    As a social worker with our Client, you influence and ensure the best clinical care for your patients. You leverage an integrated technology platform and are complimented by an entire team of professionals including registered nurses, nurse care managers, health coaches, dieticians, pharmacists, psychiatrists, social workers, and even cardiologists and podiatrists – all within the culture of  family.

    Primary functions of this role:

    • Serve as a key member of the High-Risk Care Team, in partnership with an NP, RN, and support staff, as well as practice-based care teams, to follow a team-identified panel of patients until their needs have stabilized. Care interventions will primarily be delivered via phone, in the PCP office and/or in the home.
    • Support high risk, high need patients and their families to address barriers to their overall care and management of chronic conditions.
    • Work with patients and caregivers to understand barriers to accessing appropriate care and assist in developing a care plan for chronic condition management and overall care
    • Support care team in executing care plans
    • Meet patients where they are at - both physically and mentally, to support care. Provide support in the home, in facilities, or via phone based on patient need.
    • Facilitate conversations around goals of care, patient values, and Advance Care Planning
    • Work with external partners such as discharge planners, UM staff, insurance case managers, state agencies such as Medicaid and SNF case managers to facilitate care
    • Refer patients to appropriate community agencies and resources. Support care team in navigating community referrals.

    Qualifications:

    • Must have a master’s degree in Social Work and relevant experience
    • Experience with team-based care, excellent collaboration skills
    • Experience with integrated MSW in a PCP office or home-based setting
    • Excellent working knowledge of community resources, assessing social
    • determinants of health, medical terminology, and working with a geriatric population
    • Exceptional capacity to multitask
    • Self-directed
    • Comfort with ambiguity
    • Strong communication and teaching skills.
    • Daily access to a vehicle with valid driver’s license

    How You are Supported

    • You will benefit from an exceptional total rewards package, including competitive base pay with bonuses, paid time off starting at 4 weeks for full time employees, 11 paid holidays per year, reimbursement for continuing medical education, 401k with match (coming soon), health, dental, and vision insurance.
    • Family friendly policies that support paid parental leave and flexible work arrangements
    • As a team member you’ll be supported by our robust commitment to training and development that starts with onboarding and continues throughout your career.
    • You will collaborate with like-minded healthcare professionals who, like you, understand the importance and value of a high-quality, value-based, care model.