Social Worker - LCSW

About the Position The LCSW delivers primary, urgent, and acute care and counseling to a wide variety of patients with social and behavioral problems in their homes. The LCSW will be accountable for caring for patients, connecting patients and their families to support services, maintaining accurate and current patient records, and scheduling and administering initial, urgent, and follow‑up appointments as required. The successful candidate will work with physicians, advanced practice clinicians, and a care team coordinator, assisting in delivering quality care to every patient. Job Description Practices the WellBe mission: To help our patients lead healthier, meaningful lives by delivering the most Complete Care. Performs psychosocial assessments and provides therapeutic services to patients and their families. Works closely with Behavioral Health Medical Director to manage complex patient cases and transitions of care. Provides a resource for the WellBe communities in managing complex Behavioral Health cases. Manages complex behavioral and psychosocial needs that result in improved clinical and financial outcomes. Maintains constant communication with patients when addressing their concerns and goals and helps them keep positive attitudes. Builds rapport with patients and their families and relays all concerns to the WellBe provider/IDT. Assists members to effectively utilize available resources to meet their personal health goals and helps them develop their own capabilities. Monitors patient progress and adjusts patient treatment plan as needed. Coordinates with other healthcare providers, agencies, and community resources to create a thorough treatment plan addressing social, cultural, and financial needs. Collaborates with the interdisciplinary team and participates in regularly scheduled team meetings. Ensures compliance with regulatory agencies and WellBe clinical guidelines. After a thorough assessment completed by an Advanced Practice Clinician, the WellBe social worker partners with the community team to refer patients to appropriate no‑ or low‑cost services such as Meals On Wheels (MOW), local Area Agencies on Aging (AAA), Senior & Assistance Programs, and transportation resources. Involves the patients’ families and primary caregivers as needed to achieve the best care decisions and outcomes. Effectively collaborates with all those involved in the member’s care, including health services contractors (e.g., Home Health, Hospice, Community Agencies), to meet the patients’ care goals. Consults with and advises the Clinical Team regarding the relationship of social, emotional, and cultural factors to health and medical care, and to the availability of social services in the community. Complies with safety policies and procedures, identifying and immediately reporting any potential or actual unsafe acts or conditions to their supervisor/team, and takes necessary measures to ensure a safe environment for oneself, co‑workers, contractors, participants, visitors, and others. Consistently meets or exceeds WellBe targets for productivity, customer service, quality assessment, and performance targets. Understands the importance of community involvement and participates as appropriate in activities that link WellBe to its communities. Maintains current written progress notes and other documentation on the member Medical Record, including signed and dated documentation for all services performed the day the service is provided. Participates in program and policy development of the WellBe Social Work program. Other tasks needed to accomplish the team’s objectives/goals. Job Requirements Must Haves Master’s Degree in Social Work. 5+ years clinical social work experience with the geriatric population. Two years social work experience, preferably in health care, and a minimum one‑year experience working with a frail/elderly population. License, Certification, Registration LCSW licensure required. Required Skills and Abilities Current unrestricted LCSW license in applicable state(s) required. Age‑specific competency in working with the elderly and knowledge of community services for the elderly and their families. Ability to make psychosocial assessments and develop and implement viable care plans. Must be familiar with EHR medical documentation. Strong computer skills, including Word, Excel, and PowerPoint. Strong verbal, written, presentation, and interpersonal communication skills. Bilingual in English/Spanish preferred. Ability to work effectively in a team environment. Knowledge of social work principles and practices, including case management and counseling techniques. Ability to empathize with clients. Ability to provide after‑hours services as needed. Ability to leverage internal and external resources as part of a patient’s treatment plan. Experience writing assessments and reports to monitor client progress. Valid driver’s license, access to a car, and willingness to drive to patient homes/patient location as well as an active auto insurance policy. Supervisory Responsibility : This position will have supervisory responsibility. Travel Requirements : Travel may be required up to 80% locally. Work Conditions : Ability to lift up to 20 lbs. Moving, lifting, or transferring of patients may involve lifting of up to 50 lbs as well as assist with weights of more than 100 lbs. Ability to stand for extended periods. Ability to drive to patient locations (e.g., home, hospital, SNF, etc.). Fine motor skills/visual acuity. Legal Statements Work is at‑will. This job description does not constitute an employment contract. WellBe is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected status. WellBe Senior Medical is committed to complying with the Americans with Disabilities Act (ADA) and applicable state and local laws. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job. WellBe does not offer employment‑based visa sponsorship for this position. Applicants must be legally authorized to work in the United States without the need for employer sponsorship now or in the future. Employment is contingent upon successful completion of a background check, as permitted by law. The company conducts monthly FACIS checks on all employees. Continued employment is contingent upon satisfactory results of these checks, in accordance with applicable laws and regulations. All successful candidates are required to complete a pre‑employment drug screening. Ongoing employment may also be contingent upon compliance with the company’s Drug‑Free Workplace Policy, which includes random, post‑accident, and reasonable‑suspicion drug testing. #J-18808-Ljbffr WellBe Senior Medical