BILINGUAL SOCIAL WORKER (LCSW/LMSW)

• Opportunity to work in a dynamic, fast-paced and innovative care management company that is transforming the delivery of kidney care.
  
• 3-4 Days of Home Visits (within 1 Hour Radius of Assigned Territory) and 1-2 Days of Telehealth
  
• Coordinating Services for the underserved population not providing direct therapy
  
• Competitive salary and bonus.
  
• Flexible paid leave and vacation policy.
  
• Laptop, mileage reimbursement, phone allowance, and extra perks available!
  

Responsibilities

• Perform in-home care management visits to assess and impact social and behavioral status
  
• Work closely with Care Team to ensure continual progress on all care management goals
  
• Assess social determinants of health needs and develop a plan for addressing them
  
• Perform behavioral, environmental and social support assessments and surveys as needed
  
• Deliver individual, family and group education on living with chronic illness
  
• Engage family and social support groups in the education and care of patients
  
• Assess patients and refer to behavioral health specialists if diagnosis and treatment needed
  
• Help patients to understand, accept and follow medical and lifestyle recommendations
  
• Serve as the point of contact for patient questions regarding social and behavioral
  
• Facilitate conversations around and consideration of proactive care decisions, especially relating to transplantation, home modalities and AV fistula placement
  
• Initiate patient relationships through enrollment and onboarding processes
  
• Review and document patient updates and progress in care management platform.
  
• Identify, vet and build relationships with local Community-Based Organizations
  
• Introduce patients to appropriate resources and act as the patient advocate
  
• Serve as subject matter expert on social determinants for other members of the Care Team
  
• Occasionally visit patients or take call remotely on some nights and weekend
  

Requirements

• Master’s Degree in Social Work, behavioral sciences or other related field
  
• Must be a Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW) in the State of New Mexico
  
• 2+ years previous experience working in care management and/or with chronic illness within a medical environment i.e. home health, dialysis, hospice
  
• Ability to show empathy and quickly build relationships with patients and local CBOs
  
• Ability to occasionally visit patients or take call remotely on some nights and weekends
  
• Must be fluent in Spanish
  
• Excellent verbal communication skills both in person and on the phone
  
• Ability to work with Microsoft Office and mobile phone and web-based applications
  
• Self-starter with the ability to work independently with minimal supervision
  
• Must be a road warrior! A lot of driving involved.
  
• Ability to travel to company main location in Nashville for training if necessary
  
• Must live within 30 miles of Albuquerque