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The Medical Social Worker plays a critical role at Oak Street Health Centers by supporting the psychosocial needs of patients. This role involves assessments, advocacy, and comprehensive care coordination for high-risk patients while working in collaboration with interdisciplinary care teams.
Job Responsibility:
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 (if necessary) 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, as appropriate
Navigate patient insurance benefits in collaboration with the Patient Relations Manager (PRM)
Provide both longitudinal and episodic comprehensive care coordination
Educate patients on supportive care options and provide counseling, support, and advocacy
Provide psychoeducation to patients and families
Meet with care teams to collaborate and generate solutions
Complete concise and comprehensive documentation
Partner with Community Health Workers and offer clinical guidance
Respond to crises and prioritize work
Other duties as assigned
Requirements:
Master of Social Work degree required from a school of social work accredited by the Council on Social Work Education (CSWE)
Minimally licensed in the state where OSH Center is located
Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve (where necessary)
Proficient computer skills (including Microsoft, GSuite, and electronic medical records)
US work authorization
Nice to have:
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
What we offer:
Affordable medical plan options
401(k) plan (including matching company contributions)
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