Licensed Clinical Social Worker

Licensed Clinical Social Worker (LCSW)

The Social Worker provides support to patients with complex health needs and are an integral part of our coordinated care team which includes physicians, nurse practitioners, nurses, care coordinators, social workers, dietitians, educators and pharmacists. The Strive Social Worker must be able to work successfully both in person and remotely via telephone or videoconferencing technologies. The Strive Social Worker is responsible for addressing non-clinical barriers to care and screening for social determinants of health.   

Essential Functions

• Arrange, coordinate, monitor, evaluate, and advocate for support services to meet patient clinical, behavioral and social health needs
• Provide counseling, education, and crisis intervention
• Build a strong relationship with the patient and their family and then investigate the social factors that are influencing their health with empathy, trust, and compassion
• Educate the patient and patient’s family on condition, treatment, and benefits of selected interventions
• Collaborate with multidisciplinary treatment team including patients’ primary care providers, case managers, care coordinators, and others 
• Understand what the patient wants for his or her life and work to remove the barriers 
• Collaborate with the Nurse Practitioner to ensure clinical instructions are followed by the patient and the patient needs are communicated to the NP
• Support and coach care team on effective identification of emotional and psychosocial health needs and promote sensitivity to mental health in their daily practice
• Help patients locate and access community resources. Assist patients above and beyond making a referral. Social workers will help drive engagement with resources.
• Educate the entire care team on community resources and pull together resource information so they can make simple referrals
• Assess home environments to understand deeper issues impacting patient health
• Get involved with patient’s adherence challenges and high risk situations (like high ER utilization) to solve for them
• Develop collaborative relationships with dialysis unit social workers
• Meet in person with internal and/or external stakeholders to facilitate team and business priorities/opportunities. 
• Serve patients in person and in multiple care settings (e.g., patient home, clinics) in addition to virtual visits.   

Minimum Qualifications

• Master’s degree in social work required
• Licensed Clinical Social Worker Certificate
• Minimum 5 years’ experience working in chronic disease management (e.g. internal medicine, renal, cardiac, pulmonary, or oncology care) or critical care setting
• State specific licensure required
• Business travel
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Preferred Qualifications

• Visit patients in home environment
• Ability to develop and maintain patient relationships
• Knowledge of surrounding community resources
• Strong communication skills