Social Worker, MSW

The Social Worker, MSW plans, organizes and implements social work services to participants and their caregivers in accordance with InnovAge policies and all applicable regulations. Conducts psychosocial assessments, participates in care planning and acts as a liaison between the participant and the interdisciplinary team. This role requires being on-site at the center and field-based work, including visits to participants’ homes and other locations, to ensure continuity of care and support. Essential Functions and Work Responsibilities Functional Category: Assessment & Care Planning Conducts initial psychosocial assessments (including SLUMS, PHQ-9, housing, food, financial security, MDPOA/decision-maker status). Completes in-person reassessments at least every six months or as required. Performs in-home visits as required by regulations or as indicated Participates in IDT meetings, morning huddles, mini-teams, and PDPM meetings to ensure coordinated care. Facilitates and documents participant care conferences, family meetings, and facility partnership meetings. Participates in discharge planning and plan of care development, ensuring problems, interventions, and goals are well defined. Supports participants transitioning between residences #J-18808-Ljbffr