Job Description

Job Description

The Position: Under the general supervision of the Social Work Supervisor, the Social Worker is a mental health professional, helping the frail and elderly PACE participants find solutions to a wide range of social problems, serves as an integral member of an Interdisciplinary Team (IDT) and is responsible for performing psychosocial assessments, developing and implementing plans of care, and facilitating communication between the participant, family and CEI staff.

Duties and Responsibilities:

• Serves as an interdisciplinary team (IDT) member responsible for developing and implementing a comprehensive, integrated plan of care, monitors progress toward objectives by evaluating behavioral adjustments, and communicates participant changes to team members.
• Participates in regularly scheduled behavioral management meetings with other mental health professionals.
• Attend ongoing psychosocial rounds with consulting psychiatrist; presents cases as indicated by IDT.
• Completes initial assessments, re-assessments, and care plan updates for participants while continually evaluating the participants' social service needs and their families.
• Complete chart notes accurately and timely.
• Makes referrals to community resources, including those necessary for financial management, benefit eligibility, and to address related participant needs.
• Review historical information, including requisitions for prior medical records; make an effort to resend for these if not in the chart at the time of initial psychosocial assessment, including requisition of prior records and information.
• Manages assigned caseload; prepares narrative and other reports, documents, and correspondence regarding client status; documents case files.
• Responds to, investigates, and reports complaints of elder abuse.

• Conducts 30-day conferences and annual reviews, and as-needed family and/or caregiver conferences.
• Develops and maintains working relationships with other agencies, such as the Department of Social Services, psychiatric facilities, hospitals, social agencies, and may participate in hospital and/or SNF discharge planning.
• Maintains the confidentiality of all company procedures, results and information about participants, clients or families in conformance with Health Insurance Portability and Accountability (HIPPAA) principles.
• Makes home visits, hospitals, and travels to other places to meet with participants and service providers.
• Performs related duties as assigned.

QUALIFICATIONS:

• Masters’ degree in Social Work from an accredited school of social work 
• One year experience working with a frail and/or elderly population preferred.

• Demonstrated ability to work in a multicultural and multidisciplinary team environment.
• Ability to work with minimal supervision.
• Excellent oral and verbal communication and meeting facilitation skills.
• Experience working with severe mental illness is desirable.
• Bilingual ability preferred (Spanish, Korean, Cantonese, and/or Mandarin).
• Valid California driver's license, acceptable driving record and insurance with access to a reliable transportation.
• Current CPR and First Aid

The above job description is intended to communicate the general function of the mentioned position and by no means shall be considered an exhaustive or complete outline of the specific tasks and functions that will be required. CEI reserves the right to change job descriptions, site assignments, and or work hours as required by the needs of the program. All employees are expected to perform their duties within their ability as required by the job and/or as requested by management.

Center for Elders’ Independence is a PACE (Program of All- Inclusive Care for the Elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an Adult Day Health Center, and promoting autonomy, quality of life and the ability of individuals to live in their communities. Unlike other healthcare plans, CEI is not a "fee-for-service" plan. It is a “capitation” healthcare plan. CEI is paid a set amount for each person enrolled in our program, whether or not that individual seeks care. We are a growing company that offers stability and continues to thrive.

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