Home Health Social Worker

The Role:

As a Home Health Social Worker, you will play a critical role in evaluating the psychosocial needs of patients and their families. You will work closely with nurses, physical therapists, and physicians to ensure that our patients have the resources, support systems, and care plans they need to recover safely at home. If you are passionate about community health, patient advocacy, and making a tangible difference in people's lives during vulnerable times, we want to hear from you.

Key Responsibilities:

• Assessments: Conduct comprehensive psychosocial and financial assessments of patients in their homes to identify barriers to recovery or safety risks.
• Care Planning: Develop and implement individualized care plans in collaboration with the clinical team, patients, and their families.
• Resource Navigation: Connect patients with community resources such as Meals on Wheels, transportation services, caregiver support, and financial assistance programs (Medi-Cal, IHSS, etc.).
• Crisis Intervention: Provide short-term counseling, crisis intervention, and emotional support to patients and families coping with illness, grief, or end-of-life transitions.
• Discharge & Transition: Assist with long-term care planning, advance directives, and transitions to higher levels of care or hospice when necessary.
• Documentation: Maintain accurate, timely, and Medicare-compliant clinical documentation in our electronic medical records (EMR) system.

Qualifications:

• Education: Master of Social Work (MSW) degree from a school of social work accredited by the Council on Social Work Education (CSWE).
• Experience: Minimum of 1 year of social work experience in a healthcare setting (home health, hospice, hospital, or skilled nursing facility).
• Knowledge: Strong understanding of Medicare/Medi-Cal regulations, HIPAA compliance, and local Los Angeles community resources.
• Mobility: Valid California driver’s license, reliable transportation, and active auto insurance (this is a field-based role requiring daily travel to patients' homes).
• Skills: Excellent communication, cultural competency, empathy, and the ability to work independently in a fast-paced environment. Bilingual (Spanish, Tagalog, Mandarin, or Korean) is a massive plus!

Pay: $50,418.34 - $80,718.86 per year

Benefits:

• Mileage reimbursement

Work Location: In person