Medical Social Worker (MSW) – Fee for Service (Home Care)

Centers Home•Brooklyn, NY

5d•Onsite

About The Position

The Medical Social Worker (MSW) provides short-term, resource-focused social work services to home care patients in their place of residence. This role is strictly non-therapeutic and focuses on assessing psychosocial needs, facilitating access to community resources, and supporting safe care transitions. Services are provided on a fee-for-service basis and require travel to patient homes. Scope of Practice: - This position does NOT include psychotherapy, counseling, or ongoing therapy services - Services are short-term, goal-oriented, and resource-based only

Requirements

Master’s degree in Social Work (MSW) from an accredited program
Current state licensure or eligibility as required by state regulations
Minimum of 1 year experience in healthcare, home care, case management, or community-based services preferred
Strong knowledge of community resources and social service systems
Excellent communication, organization, and documentation skills
Ability to work independently in the field
Reliable transportation and ability to travel to patient homes
Proficiency with electronic medical records (EMR) preferred
Compliance with all agency, state, and federal requirements

Responsibilities

Conduct in-home psychosocial assessments to identify social, financial, environmental, and community support needs
Educate patients and caregivers on available community resources and benefits
Assist with referrals to community agencies (e.g., housing assistance, transportation, financial aid, food programs, long-term planning resources)
Support care coordination and discharge planning in collaboration with the interdisciplinary care team
Provide guidance related to advance directives, healthcare proxies, and long-term care planning (as appropriate)
Document visits accurately and timely in accordance with agency policy and regulatory requirements
Communicate findings and recommendations to clinical management and care team members