Social Worker (PACE)

CalOptima Health•Garden Grove, CA

18d•$68,015 - $108,824

About The Position

Join Us in this Amazing Opportunity The Team You’ll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Social Worker (PACE) and help shape the future of healthcare where you’ll be an integral part of our PACEC - Social Work team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for direct social work care management services, such as participant screening, case management, counseling and referrals of participants to PACE. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 70% - Care Management Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Participates in the Interdisciplinary Team’s (IDT) initial, six (6) month and annual assessments, as well as care planning of the participant's case in accordance with industry and departmental standards. Documents participant changes appropriately in the medical record in accordance with industry and departmental standards. Communicates effectively and openly with other IDT members on participant status and needs. Assesses patients for high-risk situations such as suicidal/homicidal ideation and abuse. Reports appropriately in accordance with legal and ethical standards of practice and engages in safety planning with participants and/or family. Develops and leads group counseling and participant support group activities. Refers participants and families to appropriate community agencies or facilities, serves as a liaison with such organizations and as an advocate for participants. Assists in the completion of advance directives, mortuary arrangements, funeral planning and/or facility placement. Aids patients/representatives in ascertaining third-party and financial resources and planning for financial coverage for services as necessary. Addresses any psychosocial needs that may require social work support and intervention (e.g., anxiety, depression and other behaviors), both at the center and at home. Works with PACE participants and the IDT to develop an appropriate discharge plan for disenrolling from PACE services. May be required to perform home visits to private homes of CalOptima Health’s PACE participants; frequent travel in Orange County. Support PACE participants with care coordination needs, such as transportation, family communication, scheduling visits to the center, supporting with warm handoff process to our community partners. Represents and supports the participant’s care management needs by being an advocate for their care, supporting clinical needs such as supportive counseling, developing care plans to manage all psychosocial needs (i.e., establishing support systems, coping mechanisms, assessing depression, anxiety, cognition) and developing interventions. 25% - Support Services Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department. Consults with and advises staff members regarding the relationship of social, emotional and cultural factors to health and medical care and the availability of social services in the community. Attends and participates in in-services, staff meetings and case conferences. Helps support the new enrollee process of enrollment into the PACE program (e.g., communicates to IDT and ensures all service gaps are covered prior to enrollment). Participates in program improvement for the Social Work department. Works with the Quality Improvement (QI) department to support grievances, appeals and advocacy consistent with participant’s rights. 5% - Other Completes other projects and duties as assigned.

Requirements

Master’s degree in social work from an accredited college or university PLUS 2 years of experience in a health-related field required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
1 year of experience working with the elderly population with relevant experience within the last 3 years required.
CPR and First-Aid Certification required or must be obtained within six (6) months of the date of hire.
Valid driver’s license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 30% of the time or more.
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Nice To Haves

1 year of case management experience with the elderly population.
Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese).

Responsibilities

Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
Participates in the Interdisciplinary Team’s (IDT) initial, six (6) month and annual assessments, as well as care planning of the participant's case in accordance with industry and departmental standards.
Documents participant changes appropriately in the medical record in accordance with industry and departmental standards.
Communicates effectively and openly with other IDT members on participant status and needs.
Assesses patients for high-risk situations such as suicidal/homicidal ideation and abuse.
Reports appropriately in accordance with legal and ethical standards of practice and engages in safety planning with participants and/or family.
Develops and leads group counseling and participant support group activities.
Refers participants and families to appropriate community agencies or facilities, serves as a liaison with such organizations and as an advocate for participants.
Assists in the completion of advance directives, mortuary arrangements, funeral planning and/or facility placement.
Aids patients/representatives in ascertaining third-party and financial resources and planning for financial coverage for services as necessary.
Addresses any psychosocial needs that may require social work support and intervention (e.g., anxiety, depression and other behaviors), both at the center and at home.
Works with PACE participants and the IDT to develop an appropriate discharge plan for disenrolling from PACE services.
May be required to perform home visits to private homes of CalOptima Health’s PACE participants; frequent travel in Orange County.
Support PACE participants with care coordination needs, such as transportation, family communication, scheduling visits to the center, supporting with warm handoff process to our community partners.
Represents and supports the participant’s care management needs by being an advocate for their care, supporting clinical needs such as supportive counseling, developing care plans to manage all psychosocial needs (i.e., establishing support systems, coping mechanisms, assessing depression, anxiety, cognition) and developing interventions.
Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
Consults with and advises staff members regarding the relationship of social, emotional and cultural factors to health and medical care and the availability of social services in the community.
Attends and participates in in-services, staff meetings and case conferences.
Helps support the new enrollee process of enrollment into the PACE program (e.g., communicates to IDT and ensures all service gaps are covered prior to enrollment).
Participates in program improvement for the Social Work department.
Works with the Quality Improvement (QI) department to support grievances, appeals and advocacy consistent with participant’s rights.
Completes other projects and duties as assigned.

Benefits

You’ll enjoy competitive compensation for this role.
Our current hiring range is: Pay Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192).
The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.
This position is approved for Full Office (If the position is Telework, it is eligible in California only)
A comprehensive benefits package
CalPERS pension program and additional retirement packages.
Additional benefits and perks including:
A generous PTO program
A quality work life balance
Various wellness programs
Tuition Reimbursement
Professional development opportunities
Career development opportunities
Flexible scheduling
And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.