Description

You will provide clinical social work support to primary care patients by addressing social determinants of health and coordinating essential community resources.

Responsibilities

• Conduct in-person or remote social needs screenings and assessments for patients referred by primary care providers.
• Manage social support navigation for food insecurity, housing insecurity, and other social determinants of health.
• Execute case management activities, including discharge planning, follow-up care, and patient education.
• Coordinate specialty and imaging referrals, including scheduling, tracking, and obtaining necessary medical records.
• Maintain updated resource lists for SDOH and specialty referrals, including eligibility and contact details.

Required Skills

• 5+ years of professional experience in social work or a related clinical field.
• Proven ability to develop and follow care plans.
• Experience with case management and discharge planning in a clinical setting.
• Ability to navigate social service agencies and community resource networks.
• Experience managing patient assistance programs and prescription discount options.
• Strong documentation skills for maintaining accurate patient medical records.
• Ability to coordinate with multidisciplinary teams including nurses and primary care providers.

Preferred Skills

• Any graduate degree in social work or related clinical field.

Key Skills

Education

ANY GRADUATE