Social Worker - LISW

Job Summary About Us: Come reimagine care with us! We’re on a mission to change the way medical care is delivered around the country. By supplying home‑based medical care to patients who need it most, WellBe is changing lives by providing care wherever our patients call home. WellBe’s primary care services are delivered by a team of licensed clinicians in the comfort of the patient’s home. By combining the strength of physicians, nurse practitioners, social workers, paramedics, and other healthcare professionals, WellBe delivers an extra level of support to the patients we serve in their communities. This high‑risk population is typically underserved and challenged with access to care which we provide. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. WellBe’s clinician‑led geriatric care teams provide concierge‑level medical care and social support in the home as well as delivering and coordinating across the entire care continuum – from chronic care and urgent care in the home to hospital to skilled nursing facility to assisted living to palliative care, to end‑of‑life care. Joining WellBe means joining a growing, purpose‑driven organization to deliver the highest quality care to our senior communities and to make an impact on lives every day. Why WellBe? WellBe’s Culture is Welcoming Be part of something important: Be part of pioneering a new way of healthcare that is revolutionizing the industry. A patient‑focused environment that ensures patients can live a fulfilling life whatever their health level is. Our focus is to give our patients more good days. Give yourself incredible opportunities: Growth and development opportunities across expanding markets in the company and celebrate success on a global scale. Training in the WellBe model and team‑based care. Full in‑person orientation, vision, mission, and values introduction, and instilling cultural ideals. Respect and trust for how you work and how you make a difference. Work as part of a collaborative team with a strong team culture. You own your role, contribute to the team, and feel the enormous impact on lives. Leadership that listens, trusts, empowers, and supports. Empowerment and ownership for solving problems that arise and doing the right thing in each interaction. Pioneering a new way of healthcare that is revolutionizing the industry. What we offer: Full‑time permanent, work seeing patients in their home, traveling around to other home locations. Work during the daytime, flexible schedule, and on‑call rotation. Rich and competitive total rewards package including health benefits, dental, vision, life insurance, dependent care reimbursement, STD/LTD, 401k match with immediate vesting, paid time off / floating holidays, commuter/transportation (mileage) reimbursement, and educational reimbursement. The opportunity to work with a progressive company, who is making a difference each day with every patient. About the Position: Our LISWs are part of a team that provides compassionate care to the frailest elderly who have chronic and acute illnesses or injuries living in their homes. Our LISW delivers primary, urgent and acute care and counseling to a wide variety of patients with social and behavioral problems. The LISW 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 to patients as required. The successful candidate will work as a team with our physicians, advanced practice clinicians, and care team coordinator will assist in delivering quality care to every patient. We offer a positive, upbeat work environment where all medical personnel work together for the good of the patient. Job Description WellBe LISW – Social Worker – What to Expect: 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. Work closely with Behavioral Health Medical Director to manage complex patient cases and transitions of care. 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 helping them keep positive attitudes. Builds rapport with patients and their families and relay all concerns to WellBe provider/IDT. Assists members to effectively utilize available resources to meet their personal health goals and help 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. Following a thorough assessment completed by an Advanced Practice Clinician (APC), the WellBe social worker partners. Partner with community team to refer patients to appropriate no or low‑cost community services that support health and independence such as Meals On Wheels (MOW), local Area Agencies on Aging (AAA), Senior & Assistance Programs, and transportation resources. Involves the patients’ families and primary caregiver(s) as needed to achieve the best care decisions and outcomes. Effectively collaborates with all those involved in the members’ care, including health services contractors (i.e., 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. 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 service performed the day the service is provided. Participates in program and policy development of the WellBe Social Work program. Other tasks needed to accomplish team’s objectives/goals. Job Requirements Must Haves: Educational/Experience Requirements: 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 minimum one‑year experience working with a frail/elderly population. License, Certification, Registration LISW Licensure required. Required Skills and Abilities: Current unrestricted LISW 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, have access to a car and willingness to drive to patient homes/patient location as well as an active auto insurance policy. Supervisory Responsibility: Not applicable for this role. Travel requirements: Travel may be required up to 80% locally. Work Conditions: Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs. Ability to stand for extended periods. Ability to drive to patient locations (ie. home, hospital, SNF, etc). Fine motor skills/Visual acuity. WellBe Senior Medical is an equal opportunity employer. We embrace diversity, inclusion, and equity and encourage all interested readers to apply at wellbeseniormedical.com/careers. The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change, or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role. #J-18808-Ljbffr WellBe Senior Medical