Social Worker

ABOUT USA Specialty Path to Good HealthUpperline Health is the nation's largest provider group dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of transforming specialty care, Upperline Health is a pioneer in bringing value-based care models into specialty care. Upperline delivers a more efficient path for patients to receive consistent and effective treatment for chronic illnesses.Triage is temporary.Treatment is transformative.Upperline Health providers coordinate patients' care among a team of specialists -- physicians, advanced practice providers, care navigators, pharmacists, dieticians, and social workers for integrated treatment that addresses patients' immediate and long-term health needs.We put patients at the center of value-based care.About the Social WorkerUpperline Health is seeking a Social Worker who will be responsible for providing supportive and medical social services to patients and their families in the home. This will include a range of tasks such as directly providing support to Upperline's patients and families in the home as well as coordinating patient transition from facility to the home. The Social Worker assists the medical team in completing comprehensive psycho-social assessment to identify issues related to social determinates of health and collaborate in care plan development as a vital part of the interdisciplinary team to address individual patient's unique psychosocial needs, health status, and overall goals and values.Ideal candidates will have experience working with Medicare patients. Most importantly, candidates must demonstrate compassion for patient needs, have great attention to detail and thrive in a collaborative environment.What You'll DoAssess and provide intervention to address patient and family physical and psychosocial needs in collaboration with the interdisciplinary teamCommunicate with other Upperline clinical team members, patient's other physicians and patient's other medical providers to coordinate optimal care and resources for the patient and his or her family, including social support and transportation needs, financial counseling, identifying non-clinical community resources, mitigating family dynamics and patient compliance issues, and assisting patients in logistically accessing available healthcare servicesAssess, identify and close clinical and non-clinical gaps in patient careAppropriately triage and escalate routine, urgent and emergent patient callsDocument social work assessments, care plans, and interventionsProvide brief, targeted counseling and intervention for psychosocial, emotional issues related to social determinants of healthCollaborate with field-based NPs and physicians to develop and implement effective treatment plans and interventions for complex patient care issuesIdentify community resources and assist Upperline's patients and families in accessing those resourcesComplete various clinical and administrative tasksParticipate in weekly interdisciplinary team meetingsComplete other related duties as deemed necessary by Upperline HealthQualifications of the Social WorkerMaster's degree in social work from an accredited institution is requiredMinimum of 3 years social work experience required, preferably in a centralized care management team environmentPrior healthcare experience serving chronically ill patients living with limited resources, serious emotional disturbance, and/or mental illness preferredTelephonic case management or care coordination experience preferredStrong customer-service orientationPatient, compassionate and professional demeanor requiredExceptional organizational skills and ability to multi-taskSelf-starter with an entrepreneurial spirit and demonstrated problem-solving skillsStrong writing, Word, Excel, and database management skillsExtremely strong work ethicExperience working in a fast-growing, rapidly changing environmentBenefitsComprehensive benefit options include medical, dental and vision, 401K and PTO.CompensationCompensation is commensurate to compensation for similar positions in the region and based on prior training and experience Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.