Social Worker MSW

Description

WHO WE ARE:

Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible?

Bakersfield County Program of All-Inclusive Care for the Elderly (PACE) is dedicated to providing its participants with comprehensive health and social supports that are proven to effectively manage chronic conditions and to reduce the risk for premature institutionalization. PACE staff are leaders in the “aging in place” industry and we have had the honor of serving Fresno, Bakersfield and Orange County seniors and their families/caregivers.

Job Summary

Under the direction of the social work manager, responsible for direct social work case

management services to participants.  Clinical supervision is available 

Essential Job Functions

• Participate as a member of the interdisciplinary team (IDT), conduct initial, semi-annual, unscheduled, and annual assessments; attend morning updates and report changes in participants’ baseline status to appropriate staff on a daily basis.
• Involved in the development and implementation of QI activities.
• In conjunction with the IDT, may conduct the initial intake, meeting with family members and others. Coordinate ongoing family meetings, as needed.
• Obtain extensive social history from participant and/or family member upon admission to program.
• Provide individual and family counseling as needed or prescribed in the plan of care; develop and lead group counseling and support activities.
• Provide crisis intervention and advocacy as required.
• In conjunction with the interdisciplinary team, coordinate discharge planning for participants returning home from hospital or nursing facility.
• Maintain current, written case management records, including ongoing documentation of services provided, reassessment of changing needs and participant’s expressed wishes.
• Act as liaison between the participant and other agencies such as Department of Aging, Social Security Administration, Medicaid, etc.
• Assist with money management.
• Assist with ongoing financial eligibility for participants, including recertification as needed.
• Participate in participant-related conferences in the community as designated.
• Maintain confidentiality of participant information.
• Attend and participate in staff meetings, in-services, projects, and committees as assigned.
• Adhere to and support the company’s practices, procedures, and policies including assigned break times and attendance.
• Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
• Be flexible in schedule of hours worked.
• May require use of personal vehicle.

Knowledge, Skills, and Abilities

• Interest in the risk-based long-term care program to serve frail elderly in a community-based setting.
• Experience and thorough knowledge of social service principles and practices.
• Knowledge of psychosocial, behavioral, and family needs of the elderly population.
• Knowledge of financing mechanisms such as Medicare, Medicaid, and Prospective Payment Systems.
• Knowledge of the local and social service delivery systems and aging network.
• Proven ability to work in an interdisciplinary team.
• Ability to work effectively and harmoniously with the staff, the elderly, and providers of services, public, and private agencies.
• Energetic, dependable, resourceful, and flexible.
• Effective oral and written communication skills.
• Computer skills required.

Requirements

Experience

• Minimum of one (1) year of documented experience in working with the frail or elderly population required.
• Prefer experience in a community-based setting or geriatric program.
• Experience in substance abuse counseling
• Experience in working with the homeless population

Education and Certification

• Master’s degree in social work required.
• Is medically cleared for communicable diseases and has all immunizations up to date before engaging in direct participant contact.