Position Title: Social Worker, Lead (Licensed Master’s Social Worker)
Reports To: Social Work Manager
POSITION SUMMARY:
Under the leadership of the Social Work Manager, the Lead Social Worker (Licensed Master’s
Social Worker) (LMSW) works independently to assess the needs of, coordinate, and deliver
social services for participants and families/caregivers. The LMSW is a member of the
Participant Care Team (PCT) and the Interdisciplinary Team (IDT) and participates in the
assessment, intervention, management, and review of social service needs. The LMSW also
assists the IDT in determining eligibility and care needs. The LMSW provides care through a
variety of modalities, including but not limited to, bio-psychosocial assessment, interventions
that include individual and group counseling utilizing motivational interviewing, and cognitive
behavioral techniques, psychoeducation, consultation, and care planning/case management.
Additionally, the Lead Social Worker is responsible for daily clinical management, supervision,
and oversight of social workers.
SPECIFIC DUTIES AND FUNCTIONS:
Lead

• In addition to carrying a full social work caseload and being responsible for associated roles

and responsibilities (see below), the Lead Social Worker is responsible for the daily clinical
management, supervision, and oversight of social workers.

• Under the leadership of the Social Work Manager, the Lead Social Worker provides direct

oversight at their respective center.

• Lead Social Workers, in conjunction with the Social Work Manager, form the Social Work

Leadership Council, which formulates and monitors departmental goals and outcomes and
revises strategy based on performance outcomes.

• Ensures social work staff are effectively participating on the Participant Care Team (PCT)

and Interdisciplinary Team (IDT) for participant care and coordination.

• Partners with the Center Manager and the Social Work Manager to ensure effective

operations and PCT and IDT participation.

• Provides clinical supervision to limited licensed social workers and interns employed at

PACE Southeast Michigan and ensures professional development and continuing education
for all social workers employed at the Lead’s respective center.

• Represents the department on various process/quality improvement projects, initiatives,

and committees.

• Ensures compliance to departmental and organizational standards and all state and federal

regulatory requirements.

• Routinely audits social work care plans, assessments, progress notes, Level of Care

Determination (LOCD) paperwork, and disenrollment paperwork. Ensures accurate,
clinically appropriate, and timely completion of documentation.

• Performs other related duties, as assigned by leader(s).

Licensed Master’s Social Worker

• The LMSW is a member of the PCT and IDT and performs a comprehensive biopsychosocial assessments upon enrollment and at 6 and 12 month intervals thereafter.

Acute assessments are completed on an as-needed basis and aim to answer specific referral
questions. Utilizes measurement-based care.

• Develops and implements appropriate, individual treatment plans for both Participants and

caregivers, including but not limited to:
o Individual and/or group counseling (utilizing Motivational Interviewing and CBT
techniques)
o Education
o Consultation services to the Care Team
o Risk Assessment/Crisis Intervention

• Directs case management Issues, including but not limited to:

o Housing Issues
o Financial Issues
o Safety Issues including, but not limited to: symptoms of abuse, neglect or
exploitation; ability to live independently; decision-making capacity; any other issues
warranting involvement of Adult Protective Services (APS)
o Psychiatric: Changes in mood, behavior, cognition/mental status; suicidal/homicidal
ideation; substance use/misuse
o Caregiver Burden
o Identifies the need to transfer to a higher level of care (e.g., Behavioral Health
Services).
o Assists in coordinating discharge planning activities and processes.
o Assists in coordinating 24-hour care as indicated by interdisciplinary team and/or
the Care Team.
o Educates and counsels the participant and/or caregiver regarding care needs,
options and other related problems.
o Advocates to others on behalf of the participant, and demonstrates accountability in
resolving participant concerns or issues.

• Works collaboratively to develop and communicate initial impressions, plans of care,

changes in care, and progress in a timely fashion.
o Helps to develop and complete the plan of care with the IDT, participant, and/or
caregiver.
o Completes timely and accurate documentation in the electronic health record (EHR).
o Communicates changes in participants with IDT and family members.

• Evaluates participant outcomes and or progress toward achieving the objectives and goals

of the care plan and communicates this information among other members of the PCT and
IDT.

• Performs other related duties, as assigned by leader(s).

QUALIFICATIONS (knowledge, skills, abilities):

• Master’s Social Worker from an accredited school of social work.
• Licensed to practice in the State of Michigan. LMSW required.
• Three years' experience working as a clinical social worker, preferably in the field of

geriatrics. Knowledge of the principles of human behavior, individual and group therapy
techniques (preferably CBT and DBT), short-term interventions, and substance use
disorder assessment and treatment.

• One year experience in supervision/management/leadership. May be substituted by

other demonstration of leadership potential and/or abilities.

• Skilled facilitator and problem solver with excellent communication and interpersonal

skills.

• Demonstrated knowledge and skill in evaluating, planning, implementing, and

monitoring patient-centered approaches to care.

• Knowledge of and compliance with applicable local, state, and federal laws and

regulations.

• Cultural competence and an ability to care for a diverse population.
• Ability to learn and use electronic health record system. Auditing experience preferred.
• Proficient in Microsoft Word, Excel, Outlook, PowerPoint.
• Positive, flexible, and solution-focused attitude with ability to collaborate effectively in a

team setting.