Licensed Clinical Social Worker

Homeward

5h • $65,000 - $85,000

About The Position

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we’re creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

As a public benefit corporation and Certified B Corp™, Homeward’s mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.

Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.

The Opportunity

Join us in reimagining rural healthcare! We’re seeking a full-time Licensed Clinical Social Worker (LCSW) who is passionate about advancing health equity and delivering high-impact, person-centered care to individuals navigating complex medical and social challenges.
Social Workers at Homeward play a critical role in supporting the whole person by addressing behavioral health needs, psychosocial factors, and barriers to care. You’ll collaborate closely with interdisciplinary teams to create lasting change for patients and communities.

Requirements

• Licensed Clinical Social Worker (LCSW) in the state of Michigan
• Master’s Degree in Social Work (MSW) from an accredited institution
• 2+ years of experience in care coordination, behavioral health, medical social work, or community-based case management
• Passion for delivering care in rural and underserved communities
• Experience working with geriatric or Medicare populations
• Experience assessing behavioral health needs, establishing plan of care and therapeutic support.
• Deep familiarity with local and state-level social service systems, including Medicaid, housing, food assistance, and behavioral health resources
• Strong clinical judgment, interpersonal skills, and documentation abilities
• Comfort using EHR systems and virtual care platforms

Nice To Haves

• Experience in value-based care or risk-based arrangements
• Background in integrated care delivery or interdisciplinary team models
• Strong understanding and use of technology and AI platforms
• Knowledge of trauma-informed care, harm reduction, or recovery-oriented practices

Responsibilities

• Provide telephonic and virtual support to patients, families, and caregivers
• Conduct comprehensive biopsychosocial assessments and develop care plans that address behavioral health, care coordination, and social determinants of health
• Identify and address barriers to care, including housing instability, food insecurity, transportation, caregiver strain, and behavioral health needs
• Use motivational interviewing and trauma-informed, strengths-based approaches to promote engagement and behavior change
• Assist with the coordination of care transitions between hospital, SNF, rehab, and home settings to ensure continuity of care
• Serve as a key mental health resource navigator, connecting patients with local community organizations, public programs, and behavioral health services
• Collaborate across interdisciplinary teams—including Navigators, RN Care Managers, Clinicians and CHWs—to deliver whole-person care
• Collaborate with outside organizations beyond Homeward to meet member’s needs (calling out to facilities, resource organizations, insurance resources, etc.)
• Document patient interactions, care plans, referrals, and progress in a timely, accurate, and compliant manner
• Support quality performance on CMS measures related to experience, outcomes, and social needs

Benefits

• Medical, dental, and vision insurance with 100% of monthly premium covered for employees
• Competitive salary and possible equity grant
• Ongoing bonus opportunities
• Travel reimbursement
• Loan repayment support
• Company-sponsored 401k plan + match
• Generous paid time off

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 51-100 employees