PSS Social Worker

APLA Health•Long Beach, CA

1d•$36 - $46

About The Position

Under the direction of the Program Manager, PSS/MCC, the Patient Support Services (PSS) Social Worker provides coordinated health care services for APLA Health & Wellness patients. The position focuses especially on patients who have difficulty staying engaged in primary and HIV medical care because of psychosocial stressors, including homelessness, post-traumatic responses, mental health challenges, or complicated medical co-morbidities. The Social Worker engages patients primarily in clinical settings and, as needed, in their homes or elsewhere in the community. Using a trauma-informed approach, the position conducts outreach and engagement, screenings, resource linkages, ongoing assessment, case planning, and direct case management as needed. Services are provided through the Division of HIV and STD Prevention.

Requirements

Master’s degree in Social Work, Counseling, Psychology, or a related field from an accredited social work program.
At least one year of experience providing care coordination or case management in a clinical or community-based setting.
Experience working with culturally diverse communities and the ability to be culturally sensitive and appropriate.
Strong interpersonal skills and the ability to relate to individuals with differing value systems and behavior norms.
Ability to serve individuals from diverse economic, social, racial, and cultural backgrounds.
Knowledge of interviewing and crisis management techniques.
Knowledge of psychosocial and mental health factors affecting quality of life.
Knowledge of data management, HIV/AIDS prevention, care and treatment, and substance use disorders.
Knowledge of health education principles and program evaluation.
Ability to identify and implement outreach and engagement strategies.
Ability to respond effectively to client crisis situations.
Ability to interview clients, assess their needs, and develop individual service plans aimed at resolving those needs.
Effective written and verbal communication skills.
Ability to work under tight deadlines, coordinate multiple tasks, learn specific systems quickly and thoroughly, communicate with diverse populations, identify and update community resources, proofread and format written materials, conduct group presentations, and meet assigned deadlines.
Ability to operate standard office equipment and Microsoft Office, including Word, Excel, and PowerPoint.
Valid California driver’s license, proof of auto liability insurance, and use of a personal vehicle for work-related purposes.
COVID vaccination and booster, or an approved medical or religious exemption.

Nice To Haves

Specific training or experience working with people living with HIV/AIDS.

Responsibilities

Help patients navigate and connect with eligible APLA Health resources, including benefits, housing, and other HIV-positive support services.
Provide referrals, advocacy, and service information to patients as needed.
Use the Transtheoretical Model of Behavior Change to support treatment engagement and retention, medication adherence, risk reduction, improved health outcomes, and communication with health providers.
Maintain ongoing contact with patients and monitor progress toward goals in intervention plans.
Coordinate and communicate with members of patients’ care teams, including medical providers, mental health and addiction providers, allied health professionals, community resources, and other team members.
Participate in interdisciplinary case conferences for assigned case management patients.
Document services promptly and accurately in eClinicalWorks, e2LA, and/or other charting and data collection systems, in accordance with program policies and professional standards of care.
Follow applicable professional, legal, and ethical standards for behavioral health practice, including mandated reporting, effective service provision, case documentation, patient confidentiality and HIPAA requirements, patient safety, and professional boundaries.
Attend required trainings and case conference meetings.
Prepare monthly reports and statistics as requested.
Communicate with clients and patients in English and Spanish as required by the job duties.
Perform other duties as assigned to meet business needs.