Masters of Social Worker

Job Summary

Under the   supervision of the Program Director, or Social Work Supervisor, The PACE Master’s-level Social Worker provides direct social work case management services for participants   enrolled in PACE. The Social Worker functions as a member of the   interdisciplinary team and works with participants to increase independence   and community integration through a model of self-determination. Additionally, this role will liaise between participants, members of participants’ support network, and the interdisciplinary team.

Responsibilities

• Conducts   initial psychosocial assessments on prospective program participants, and   consults with family or other support system members as needed.
• Develops   clear and timely written social service care plans, and implements same for   assigned caseload.
• Periodically   reviews social service care plans as needed or required, and revises as   appropriate.
• Maintains   regular attendance at, and participation in, interdisciplinary team meetings;   collaborates on care planning and service allocation decisions.
• Assists   families with problem solving around care-giving issues and serves as the   facilitator of family and participant meetings as needed.
• Provides   crisis intervention, and advocacy as needed for assigned caseload.
• Provides   supportive counseling to participants and families as needed.
• Develops   and facilitates support groups.
• In   conjunction with the interdisciplinary team, coordinates discharge planning   for participants returning home from hospitals, nursing homes, adult family   homes, or group homes; coordinates admissions to group homes, adult family   homes, and nursing homes.
• Assists   participants with housing issues.
• Maintains   current, well-organized case management records in accordance with social   work and Electronic Medical Record (EMR) documentation standards.
• Assists   participants with money management as needed.
• Assists   financial eligibility staff or county and state agencies in resolving   financial eligibility related issues for assigned caseload as needed.
• Attends   conferences and seminars to maintain State Social Worker certification, and   to stay informed of developing trends in geriatric, developmentally or   physically disabled social work practice.
• Develops   knowledge of community networks and resources for elderly, developmental or   physically disabled population of diverse ethnic and cultural backgrounds,   and forms collaborative relationships with same. Provides information to   participants to assist in establishing and maintaining community links.
• Advocates   on behalf of participants for benefits and services through government and   community agencies.
• Assists   participants in completing advance directives and guardianship paperwork.
• Provides   bereavement follow up as needed.
• Facilitates   participant enrollment and disenrollment from the program.
• Conducts   home visits and home assessments as needed.
• Provides   Social Work services to assigned caseload, based on program needs across   sites.
• Participates   in cross-site Social Work Department meetings, other site-based meetings and   agency-wide committees.
• Protects   privacy and maintains confidentiality of employee, participant, and sensitive   agency information.
• Supports   High Desert PACE mission and values.
• Maintains   federally compliant and timely documentation of institutionalizations, Adult   Protection Service reports/follow-ups and consultations, community contacts,   family conferences, assessments, and other case management notes in medical   records
• Attends   required staff meetings/trainings and voluntary professional development   courses
• Performs   related duties as assigned; including providing temporary coverage for other   sites as needed and assigned by your supervisor.
• Completes other projects and duties as assigned

Education & Training

• Masters degree in social work and current California Certification required.
• A minimum total of one year of personal, clinical/internship, and or employment experience providing care or services for a frail or elderly   population, and or a developmentally or physically disabled population   required
• One to two years case management experience preferred.
• Valid BLS   certification from approved American Health Association provider required   upon hire

Skills & Abilities

• Strong organizational   skills demonstrated by the ability to effectively and efficiently prioritize   and process multiple tasks.
• Clear understanding of   interdisciplinary team care planning and decision-making processes; proven   effective team contributor.
• Basic computer skills;   familiar with electronic communication, word processing and data entry.
• Demonstrates necessary   skills and knowledge as outlined in attached position-specific Competency   Assessment Profile.
• Excellent verbal and   written communication skills, including superior composition, typing and   proofreading skills
• Ability to interpret a   variety of instructions in written, oral, diagram, or schedule form
• Knowledgeable about   and experience with counseling theories and techniques
• Knowledgeable about   and experience with community resources for individuals and families
• Ability to establish   and maintain good interpersonal relationships
• Ability to   successfully manage multiple tasks simultaneously
• Excellent planning and   organizational ability
• Ability to work as   part of a team as well as independently
• Ability to work with   highly confidential information in a professional and ethical manner
• Interpersonal skills include: Initiative and resourcefulness. 
• Use of discretion, tact, patience and good judgment. 
• Empathetic   and compassionate attitude in caring for the elderly

Working Conditions

• The working conditions and physical demands described here are representative of those that must be met by an employee to   successfully perform the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• May be required to perform home visits to private homes of High   Desert PACE participants; 
• Reaches toward &/or over participants to assist them &   moves &/or picks up items
• Moves throughout the PACE Center to meet with participants &   staff
• Positions self at participant-level to communicate
• Operates a motor vehicle for transport to home visits