Medical Social Worker - LSW - $2K Sign-on Bonus

Oak Street Health - Far Rockaway, NY

Full-time - Entry Level

Far Rockaway, NY

101-250 employees

Ambulatory Health Care Services

About the position

The Medical Social Worker at Oak Street Health Centers plays a crucial role in supporting the psychosocial needs of patients, particularly those at high risk. This position involves collaboration with an interdisciplinary care team to provide assessments, advocacy, and comprehensive care coordination services aimed at improving health outcomes and reducing hospitalizations. The role emphasizes patient engagement, education, and resource navigation to empower patients in managing their health conditions effectively.

Responsibilities

• Proactively support our highest-need patients by providing comprehensive assessments, telephonic check-ins, and in-person visits.
• Partner with the patient and their support persons to identify goals, increase engagement in their healthcare, address barriers, and drive the execution of their care plan.
• Maintain extensive knowledge of community resources and make referrals to ensure the patient's healthcare and psychosocial needs are met.
• Navigate patient insurance benefits in collaboration with the Patient Relations Manager to ensure mindful utilization and maximization of plan benefits.
• Provide both longitudinal and episodic comprehensive care coordination to empower patients to independently manage their health conditions.
• Educate patients on supportive care options and provide goals of care counseling, support, and advocacy at all stages of the patient journey.
• Provide psychoeducation to patients and families surrounding life stage and disease-specific issues.
• Meet with care teams to collaborate and generate creative solutions to patient issues, and spearhead intervention in complex psychosocial dynamics.
• Complete concise and comprehensive documentation on time to ensure visibility into the status of MSW interventions.
• Partner with Community Health Workers and provide clinical guidance regarding complex patient needs.
• Respond to crises and urgent needs with the ability to prioritize work, triage situations, and multitask.

Requirements

• Master of Social Work degree from a CSWE accredited school.
• Minimally licensed in the state where OSH Center is located.
• Fluency in Spanish, Polish, Russian, or other relevant languages.
• Proficient computer skills including Microsoft, GSuite, and electronic medical records.
• US work authorization.

Nice-to-haves

• Prior experience with complex care coordination and/or population healthcare management.
• Familiarity with using metrics and data to guide practice and drive outcomes.
• Minimum one year of medical social work experience in a healthcare environment, preferably within the last two years.
• Experience working on a multidisciplinary team of other healthcare providers.

Benefits

• Paid vacation and sick time.
• 401K match options.
• Health insurance, vision, and dental benefits.