Social Worker | PACE Program
About The Position
The PACE (Program of All-Inclusive Care for the Elderly) program is designed to help older adults remain safely in their homes rather than entering nursing facilities. It provides complete medical care, rehabilitation, medications, transportation, social services, and supportive therapies—all coordinated by an interdisciplinary care team. Participants receive personalized care plans tailored to their unique needs, along with access to a PACE center for social activities, meals, and clinical services. By integrating medical and supportive care under one program, PACE helps seniors maintain independence, improve quality of life, and continue living in their communities with dignity. Helps older adults and their families manage the emotional, social, and practical challenges that come with aging and healthcare needs. They work as part of an interdisciplinary team that includes doctors, nurses, therapists, and other healthcare professionals to develop and coordinate a participant’s care plan. Social workers assess the participant’s home environment, emotional well-being, family support system, and overall needs to help them remain safely living in the community instead of moving into a nursing home. They also provide counseling and emotional support for issues such as depression, anxiety, dementia, grief, and caregiver stress. In addition, social workers connect participants and families with community resources, financial assistance programs, transportation, housing support, and long-term care services. They advocate for the participant’s needs, assist during crises, conduct home visits, and help families make important decisions regarding care planning and end-of-life support when necessary.
Requirements
- Bachelor’s or Master’s degree in Social Work (BSW or MSW) from an accredited program
- Active social work license (LMSW, LCSW, or state-required equivalent)
- Experience working with older adults, individuals with disabilities, or healthcare populations
- Knowledge of case management and care coordination
- Strong communication and interpersonal skills
- Ability to work as part of an interdisciplinary healthcare team
- Assessment, counseling, and problem-solving skills
- Basic computer and documentation skills
Nice To Haves
- Master of Social Work (MSW) if not already required
- Experience in geriatric care, long-term care, hospice, home health, or PACE programs
- Knowledge of Medicare, Medicaid, and community resources
- Experience with dementia care and caregiver support
- Crisis intervention and discharge planning experience
- Familiarity with electronic medical records (EMR) systems
- Bilingual or multilingual communication skills
- Leadership or supervisory experience
- Strong understanding of aging and chronic illness management
Responsibilities
- Helps older adults and their families manage the emotional, social, and practical challenges that come with aging and healthcare needs.
- Work as part of an interdisciplinary team that includes doctors, nurses, therapists, and other healthcare professionals to develop and coordinate a participant’s care plan.
- Assess the participant’s home environment, emotional well-being, family support system, and overall needs to help them remain safely living in the community instead of moving into a nursing home.
- Provide counseling and emotional support for issues such as depression, anxiety, dementia, grief, and caregiver stress.
- Connect participants and families with community resources, financial assistance programs, transportation, housing support, and long-term care services.
- Advocate for the participant’s needs.
- Assist during crises.
- Conduct home visits.
- Help families make important decisions regarding care planning and end-of-life support when necessary.
Benefits
- Health insurance options for employees and dependents
- Dental, vision, and prescription drug plans
- Flexible Savings Accounts (FSA) or Health Savings Accounts (HSA), with employer contributions
- Paid Time Off (PTO), Personal and Taking Care of You Days
- Holiday pay (six holidays per year)
- 403(b) ERISA Retirement Plan, match provided
- Free group life and AD&D insurance of $20,000
- On-site education center to provide professional development and CEU credits
- Free Employee Assistance Program (EAP) for employees and dependents
- Paid monthly volunteer time at non-profit organizations
- Uniform Allowance Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
