Social Worker, Mental Health

Summary

The Master’s Social Worker (MSW) works independently to assess the needs of, coordinate, and deliver social services for participants and families/caregivers. The MSW is a member of the Interdisciplinary Team (IDT) and participates in the assessment, intervention, management, and review of social service needs. The MSW provides care through a variety of modalities, including but not limited to bio‑psychosocial assessment, interventions that include cognitive behavioral techniques, psychoeducation, consultation, and care planning/case management.

• Perform comprehensive bio‑psychosocial assessments at enrollment (initial) and at 180‑day intervals thereafter; complete acute assessments on an as‑needed basis to answer specific referral questions.
• Utilize measurement‑based care and develop and implement appropriate, individual treatment plans for both participants and caregivers.
• Provide counseling using Motivational Interviewing and CBT techniques, education, and coordination of services in collaboration with the care team.
• Conduct risk assessment and crisis intervention; direct case management and address issues including housing, financial, safety, abuse/neglect, and injury.
• Assess psychiatric status, including mood, behavior, cognition/mental status, suicidal/homicidal ideation, and substance use/misuse.
• Evaluate caregiver burden and identify the need to transfer to a higher level of care.
• Assist in coordinating discharge planning activities and processes.
• Educate and counsel participants and/or caregivers regarding care needs, options, and related problems.
• Advocate on behalf of the participant and resolve concerns or issues.
• Collaborate to develop and communicate initial impressions, plans of care, changes in care, and progress in a timely fashion.
• Help develop and implement the plan of care with the IDT, participant, and/or caregiver.
• Complete timely and accurate documentation in the electronic health record (EHR).
• Communicate changes in participants with IDT and family members; evaluate participant outcomes and progress toward achieving objectives and goals of the care plan.
• Perform other related duties as assigned by leader(s).

• Master’s Social Worker from an accredited school of social work.
• Licensed to practice in the State of Michigan (limited license may be considered).
• One year experience working as a clinical social worker, preferably in the field of geriatrics.
• Overall knowledge of case management skills, short‑term interventions, and principles of human behavior.
• Demonstrated knowledge and skill in evaluating, planning, implementing, and monitoring patient‑centered approaches to care.
• Knowledge of and compliance with applicable local, state, and federal laws and regulations.
• Cultural competence and the ability to care for a diverse population.
• Ability to learn and use an electronic health record system.
• Proficient in Microsoft Word, Excel, Outlook, PowerPoint.
• Positive, flexible, and solution‑focused attitude with ability to collaborate effectively in a team setting.