Social Worker 2

Job Title: Social Worker 2
Location: Selmer, TN - 38375
Duration: 6 Months + (Possible Extension)

Position Title: Clinical Care Social Worker – Multi-Site Coverage
Location: Client sites (Centralized) – Travel between multiple primary care locations required
Schedule: Standard business hours; may vary based on site coverage and meetings
 
Job Summary:
This role supports primary care teams by providing social support navigation, case management, specialty referral navigation, and prescription assistance to patients. The Clinical Care Social Worker ensures patients’ social and medical needs are addressed, barriers to care are minimized, and continuity of care is maintained across multiple sites.
 
Key Responsibilities:
1. Social Support Navigation:

• Screen and assess social determinants of health (SDOH) for patients referred by primary care providers or nurses.
• Coordinate access to social services including housing, food, clothing, and mental health resources.
• Maintain a resource list with eligibility criteria, referral process, and contact information.
• Collaborate with primary care nurses, providers, and other social workers to identify patient and community resources.

• Conduct case management for patients including follow-up, education, and care plan monitoring.
• Assist with hospital discharge planning and obtaining patient records.
• Facilitate access to necessary medical equipment through community partners.
• Identify patients lost to follow-up and support their return to care.

• Assist patients with scheduling and coordinating non-BCS specialist appointments and imaging referrals.
• Obtain records from specialists and imaging centers.
• Maintain a referral resource list including eligibility, process, cost, and contact details.

• Help patients access low-cost prescription options and patient assistance programs.
• Support applications for programs like CoverRx, RxOutreach, and serve as liaison with drug companies.

• Participate in regional primary care initiatives with social work components.
• Document all activities in patient records, update consults, and tag relevant clinical staff.
• Provide or locate patient education resources as needed.
• Attend clinical meetings, provider meetings, and community health council sessions to strengthen partnerships with social service agencies.

• Bachelor’s degree in Social Work (required)
• Completion of onboarding and orientation

• Experience in social work, case management, or care coordination preferred
• Strong knowledge of social determinants of health and community resources
• Effective communication and interpersonal skills
• Ability to manage multiple priorities across sites
• Self-motivated and detail-oriented

• Personal computer, phone, fax, printer, scanner, copy machine, calculator
• Personal vehicle for patient visits and multi-site travel
• Other standard office equipment as required