Social Worker II - Day Program No Nights no Weekends

Fallon Health•Springfield, MA

1d•Hybrid

About The Position

Fallon Health's Summit ElderCare® is a Program of All-Inclusive Care for the Elderly (PACE) that helps people 55 and older continue living safely at home, serving as an alternative to nursing home care. The company values diversity and inclusion, striving to be a leading provider of government-sponsored health insurance programs. This role functions as a member of the PACE Interdisciplinary Team, providing social work services and support to participants, families, and caregivers. It also involves providing direction to bachelor's level social workers as assigned by the Social Work Manager.

Requirements

Master’s degree in social work
Valid and unrestricted license to practice social work from the Board of Registration of Social Work of the Commonwealth of Massachusetts.
Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed.
Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage
At least two years experience in a Social Work capacity, preferably in a community setting, with a minimum of one year experience working with a frail or elderly population.
Generally, establishes own work plan and priorities, using and/or modifying established procedures, to assure timely completion of assigned work in conformance with program policies and standards; problems lacking in clear precedent are reviewed with Manager prior to acting.

Nice To Haves

LICSW supervision offered to advance licensure.
Manage a caseload of only 65 participants in collaboration with your team which includes a provider and primary care nurse.
Assessments completed only semi-annually or for a significant change
Assist with the supervision and training of MSW student interns

Responsibilities

Participates in the intake and evaluation process by conducting the initial social work assessment, administering MSQs, developing an intake summary and presenting the social work perspective to the interdisciplinary Team.
Assures that participants rights are reviewed during the intake process.
Conducts reassessments at least semiannually and whenever there is a change in participant status or the participant /caregiver requests it.
Develops and implements a social service plan of care for each participant and updates it based on the results of reassessments or on-going changes in status.
Responsible for the maintenance of appropriate records and documentation in the medical record including at least the initial assessment, quarterly progress notes, significant changes and all participant-related interactions.
Participates as a member of the Interdisciplinary Team at daily team meetings and care planning meetings.
Assists team members to understand the social, emotional, cultural and psychosocial aspects of participants’ situations.
Acts as an advocate and liaison when counseling services are needed.
Completes documentation and record-keeping related to disenrollments, deaths and permanent placement; distributes relevant notifications.
Participates in the development, promotion and implementation of caregiver support groups or programs; leads or co-leads groups as necessary.
Assists in managing referral telephone calls as needed.
Implements program policies and procedures as directed.
Assists in the conversion of participants from community based Medicaid to long-term care Medicaid when necessary. Works collaboratively with the Operations Support Representative to assure appropriate access to Medicaid benefits.
Pursues relevant professional development. Attends appropriate workshops and in-service activities to maintain current professional status.
Consistently follows the Social Work Code of Ethics.
Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures.