Social Worker, MSW

Job Description

Job Description

Description

Schedule: Exempt, minimum 40 hours per week | Monday - Friday | 8:00 am - 4:30 pm
Department: Social Work | LifeCircles PACE | Holland, MI

What You'll Do In This Role:
The Masters Social Worker (LLMSW/LMSW) plays a vital role in supporting participants’ emotional well-being, independence, and quality of life throughout their PACE journey. Working closely with the Interdisciplinary Team (IDT), this role assesses evolving psychosocial needs, coordinates personalized support, and advocates for each participant’s goals and preferences. Through strong relationships and ongoing communication, the Social Worker helps ensure participants receive the resources, guidance, and compassionate care they need to thrive. 
Key Responsibilities

Interdisciplinary Team Collaboration and Care Coordination

• Actively participates in interdisciplinary team (IDT) assessments, care planning, and periodic re-assessments, ensuring timely communication of changes in participant’s medical status or psychosocial needs to team members.
• Coordinates discharge planning and admissions to long-term care facilities, collaborating with IDT, hospital staff, and discharge planners.

Care Planning and Case Management

• Develops and maintains person-centered care plans, including goals and interventions, and coordinates 24-hour care delivery; provides individual and family counseling, and leads group activities as needed.
• Facilitates advance care planning conversations, ensuring completion of relevant documentation and identification of a healthcare proxy.

Community Resources and Advocacy

• Links participants to entitlements and community resources, assisting with financial eligibility issues and providing advocacy.
• Consults with staff on the social, emotional, and cultural factors impacting health and medical care, advising on available community services.

Quality Assurance and Documentation

• Participates in quality improvement activities and maintains accurate social work case management records, including progress notes, care plans, and reassessments, as required by policy.

The above is a summary of the position, it in no way states or implies that these are the only duties this position will be required to perform. If selected for the position you will receive a full job description.

Skills, Knowledge & Expertise

• Must possess a Masters degree in social work (MSW) from a program accredited by the Council on Social Work Education (CSWE).
• Active LMSW/LMSW License in the state of Michigan.
• Minimum of one year of experience working with a frail or elderly population (preferred).
• Strong desire to work in a team-based model of care.
• Excellent communication skills and time management skills.
• Proficient in Microsoft Office Suite (Excel, Outlook, Word) and electronic medical records systems
• Demonstrates high ethical standards, strong sense of integrity, professionalism, critical thinking, creativity, flexibility, and problem-solving abilities.
• Comfortable working independently and managing self-directed daily responsibilities.
• Must possess a current, valid driver’s license and maintain proper auto insurance.
• Possess current CPR certification or willingness to obtain within 6 months of employment by LifeCircles.

Job Benefits

• Generous 6 weeks of Flexible time off per year —plus paid holidays on top of that.
• Competitive Benefits for Full-Time Team Members – Enjoy Medical, Vision & Dental Insurance starting on the 1st of the month after 30 days of hire.
• Retirement Savings Plan – Secure your future with employer contributions.
• Daily Pay –Instantly transfer your daily earnings. 
• Team Member Referral Bonus Program – Earn $500 when you bring great people to our team!
• Career Growth & Development – Advance your career with tuition assistance and school scholarships up to $3,000 per semester.
• Wellness Program & Reimbursemen t – Prioritize your health and well-being, reimbursed 120 a year!
• Mileage Reimbursement – Offered for work-related travel.

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