Medical Social Worker - Home Health in Fort Worth, TX

Job Description

Job Description

The Home Health Team is looking for Medical Social Worker (MSW) - Home Health. Below are the details of the position.

About Us
The Home Health Team is one of the largest privately owned Medicare-certified home health agencies in the DFW area, serving patients across 13 counties. With a hospitalization rate nearly half the national average, we are committed to delivering exceptional, patient-centered care that keeps people safe and thriving at home.

Position Overview
We are seeking compassionate and experienced Medical Social Workers (MSW) to join our clinical team across our service area. We are hiring for multiple territories — you will be assigned a defined geographic area and will not be expected to cover the entire region. The Home Health MSW plays a vital role in assessing patients’ psychosocial needs, coordinating community resources, and supporting patients and families through complex medical and life transitions — all in the comfort of their own homes.

Key Responsibilities
• Conduct comprehensive psychosocial assessments for home health patients
• Develop and implement individualized care plans in coordination with the interdisciplinary team
• Identify and connect patients and families with community resources, support services, and financial assistance programs
• Provide counseling and crisis intervention as needed
• Assist with discharge planning, advance directives, and end-of-life conversations
• Document assessments and visit notes in compliance with Medicare/Medicaid standards
• Participate in case conferences and collaborate with RNs, therapists, and physicians
• Educate patients and caregivers on available resources and coping strategies

Qualifications
• Master’s degree in Social Work (MSW) from an accredited program required
• Current Texas LMSW or LCSW license required
• Minimum 1 year of experience in home health, hospital, or post-acute care preferred
• Knowledge of Medicare/Medicaid home health regulations preferred
• Strong communication, organizational, and time management skills
• Valid Texas driver’s license and reliable transportation required
• Bilingual (English/Spanish) a plus

Salary/Pay:
$75.00 USD per visit

The Home Health Team is an equal opportunity employer.