Social Worker

On Lok • San Jose, CA

2d

About The Position

On Lok PACE We are a non-profit committed to our participants. Dedicated to The Care of Elders: PACE ( P rogram of A ll-Inclusive C are for the E lderly) was developed to answer the many problems around caring for frail seniors. The PACE model is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in their community whenever possible. Seniors, their family members, and caregivers face many issues, including transportation to appointments, management of medications, coordination of medical care from different specialists, lack of social interaction, and ability to stay alone at home. On Lok PACE participants receive in home care services and transportation to a On Lok PACE center for primary medical care, social and recreational activities, and other senior care services. We understand the importance of a system that works together. Your expertise, drive and passion can help us carry out our mission to improve lives and advance healthcare. Join our team of leaders to begin a rewarding career! POSITION SUMMARY: The Social Worker provides direct case management services to On Lok participants. The primary role of the MSW is to assist participants and their family/caregivers to cope with the social and emotional issues and practical arrangements related to maintaining their independence. With support from the Social Work Lead, the MSW serves as an integral member of the Interdisciplinary team (IDT) providing assessments, coordination, treatment planning, information and referral to community resources and other social work services to meet the complex needs of participants and their families.

Requirements

• Graduate of an accredited college with a Master's of Social Work degree.
• Minimum one-year experience with the frail or elderly.
• Experience or ability in working with a diverse population.
• Experience working within the framework of an interdisciplinary team.
• Good interpersonal skills including ability to work cooperatively on an interdisciplinary team.
• Highly organized, able to prioritize tasks and conduct thorough follow-up.
• Excellent written and verbal communication skills.
• Computer literate and basic knowledge of Microsoft Office.
• Bilingual ability may be required for specific assignments.

Nice To Haves

• Experience with electronic health record system (preferred).
• Minimum one-year post MSW experience (preferred).
• Minimum one-year case management experience (preferred).
• Minimum one-year health care related experience (preferred).

Responsibilities

• Utilize independent judgement and discretion to provide case management to a panel of participants.
• Conduct initial and routine psychosocial assessments on new and existing participants in order to develop, implement and update individualized care plans and interventions.
• Partner with caregivers and support system to develop care plan and deliver services.
• Identify risks and other psychosocial problems.
• Identify service needs of each participant; advocate, refer, coordinate and follow up in a timely fashion.
• Provide individual counseling.
• Facilitate family conferences.
• Reach out to the larger community to meet participants' specific needs.
• Assess needs and complete discharge planning when a participant dis-enrolls from On Lok.
• Facilitate participant and/or caregiver groups and participate in special events such as weekend caregiver workshops.
• Act as the main liaison between participants, caregivers, the team, and the community.
• Work with relevant departments such as Health Plan and other community agencies (e.g. RCFE, NF, DAAS)
• Adhere to all ethical and legal standards of social work practices.
• Comply with all On Lok policies & procedures including but not limited to PACE, safety, and confidentiality requirements.
• Fulfill all documentation requirements in a timely and accurate manner.
• Actively participate in team meetings, advocate for the needs of participants and their caregivers, compromise differences among team members, support and carry out team plans.
• Incorporate the Healthcare Hospitality G.R.E.A.T. Practices for 5-Star service.
• Assist in the continuous quality improvement of social work services and efficiency of systems.
• All other reasonably related duties as assigned.

Benefits

• Medical, Dental, and Vision coverage
• Retirement Savings Plan 403(b) and Term Life/AD&D Insurance
• Flexible Spending Account, Commuter Benefits, Pet Insurance, and Employee Discount Program
• Mental Wellness Resources and Employee Assistance Program (EAP)
• Holidays (10 per year), vacation time, sick leave, long-term disability insurance, and additional benefits are available.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees