Social Worker- Pilot CCM
About The Position
ROMTech is a medical technology company that has created and patented a revolutionary medical device and telemedical platform which delivers in-home rehabilitative care. Our disruptive technology has proven to yield faster recoveries and better outcomes with unmatched patient compliance. We began in orthopedics and have entered scale-up of our orthopedic business. We are now leveraging our core technology, infrastructure, and first mover position to enter cardiology, followed by other adjacent markets. Having created this new lane, we have a unique opportunity to serve as the global leader in the business, technology, and science of recovery, and to bring life-changing help to many millions of people. The Contract Social Worker supports the Chronic Care Management (CCM) program by providing psychosocial assessments, care coordination, and resource navigation for patients with chronic and complex conditions. This role contributes to improved patient outcomes, adherence to care plans, and reduced barriers to care by addressing social determinants of health and connecting patients with appropriate services. The position supports interdisciplinary collaboration and ensures alignment with CMS CCM guidelines and organizational care delivery objectives.
Requirements
- Strong understanding of social determinants of health and care coordination principles
- Excellent communication and interpersonal skills for patient engagement
- Ability to work independently and manage caseloads in a structured, outcome-focused manner
- Strong organizational and documentation skills
- Ability to navigate community-based resources effectively
- Bachelor's or Master's degree in Social Work (MSW strongly preferred)
- Active Florida Social Work License (externally required for practice — assumed)
- Ability to sit at a computer terminal for an extended period.
- Moderate noise (i.e., phone calls, online meetings, computer audio)
- Regular, predictable attendance is required.
- Must be able to communicate clearly and professionally in both verbal and written formats.
- Must be able to engage in active listening and express ideas effectively in person, by phone, and via virtual meetings.
Nice To Haves
- Experience in chronic care management or population health programs
- Familiarity with telehealth platforms and EHR systems
- Bilingual (English/Spanish)
- Experience working with Medicare or high-risk patient populations
- Background in behavioral health, geriatrics, or case management
- LCSW preferred
Responsibilities
- Conduct psychosocial assessments to identify patient needs, barriers to care, and social determinants of health
- Collaborate with interdisciplinary care teams to support development and execution of individualized care plans
- Provide short-term supportive counseling and emotional support to patients managing chronic conditions
- Identify and facilitate access to community-based resources including housing, transportation, food assistance, behavioral health, and financial services
- Support patient adherence to care plans and medication regimens through education and structured follow-up
- Assist with care transitions, including post-discharge coordination and patient support
- Maintain accurate, timely, and compliant documentation in EHR and CCM platforms
- Participate in case consultations or interdisciplinary discussions as needed to support patient outcomes
- Ensure all activities align with HIPAA and CMS Chronic Care Management guidelines
- Participate in program improvement initiatives or workflow optimization efforts as mutually agreed
- Support onboarding or knowledge-sharing activities related to CCM services if applicable
- Performs other mutually agreed upon duties consistent with the applicable engagement or contract
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What This Job Offers
Career Level
Mid Level
