The Medical Social Worker provides coordinated care in clients’ homes to patients of all ages. The role involves psychosocial assessment, analysis, counseling, and referrals to address the needs of clients and their families. The social worker supports the Agency’s admission process by evaluating clients’ psychosocial, financial, environmental, and community needs and documenting findings in the plan of care and clinical records. The role works with an interdisciplinary team and communicates with clients, families, team members, and other healthcare professionals to support desired outcomes. The position is PRN and requires local travel; work is primarily in an office environment, with availability to Agency personnel during operating hours and potentially after hours for emergencies.