We are seeking a highly qualified and compassionate Social Work Care Manager to join our client in transforming kidney care. As a Social Work Care Manager, you will play a crucial role in supporting patients with chronic illnesses by assessing their social and behavioral needs, providing education, and connecting them with essential resources. This role requires a dedicated individual with a Masters degree in Social Work or a related field, a relevant state license, and a minimum of 2 years of experience in care management within medical environments such as home health, dialysis, or hospice.

Responsibilities:

• Conduct in-home care management visits to evaluate social and behavioral status.
  
• Collaborate closely with the Care Team to ensure continual progress on care management objectives.
  
• Assess social determinants of health needs and develop comprehensive plans to address them.
  
• Perform assessments and surveys related to behavioral, environmental, and social support as required.
  
• Deliver individual, family, and group education on effectively managing chronic illnesses.
  
• Engage patients families and social support groups in the education and care process.
  
• Refer patients to behavioral health specialists for diagnosis and treatment if necessary.
  
• Assist patients in understanding and adhering to medical and lifestyle recommendations.
  
• Serve as the primary point of contact for patient inquiries regarding social and behavioral concerns.
  
• Initiate patient relationships through the enrollment and onboarding procedures.
  
• Document patient updates and progress accurately within the care management platform.
  
• Identify, evaluate, and build relationships with local Community-Based Organizations.
  
• Introduce patients to appropriate resources and advocate on their behalf.
  
• Facilitate discussions on proactive care decisions, including transplantation and home modalities.
  
• Provide expertise on social determinants to other members of the Care Team.
  

Additional Details:

• This position involves covering a one-hour travel radius.
  
• Occasional domestic travel to Nashville, TN may be required.
  
• Demonstrated ability to work independently with minimal supervision.
  
• Excellent verbal communication skills for both in-person and phone interactions.
  
• Proficiency in Microsoft Office and familiarity with mobile and web-based applications.
  
• Comfortable taking remote calls on nights and weekends.
  
• Adaptable and capable of working with ambiguity, drive time, and telehealth components.
  
• Enthusiastic about working in a dynamic start-up environment.
  

If you are a dedicated and empathetic social work professional seeking a fulfilling role in a start-up environment, we encourage you to apply for this position! You will be an essential part of our clients team, helping to redefine and enhance the care experience for patients with chronic illnesses.

• Masters Degree in Social Work, behavioral sciences, or related field.
  
• Valid Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW)
  
• Minimum of 2 years of previous Social Worker experience in care management and/or chronic illness within medical settings.
  
• Ability to take calls remotely on some nights and weekends.
  
• Self-starter with the capability to work independently and make decisions with minimal supervision.
  
• Covid-19 vaccinated.
  
• Comfortable with traveling to patients homes within a one-hour radius.
  
• Possess a valid drivers license and reliable transportation.
  

• 401(k)
  
• Dental insurance
  
• Health insurance
  
• Paid time off
  
• Vision insurance