Social Worker; PT - Pine Valley

Pine Valley, 9802 Coldwater Rd, Fort Wayne, IN 46825, USA

You are a compassionate, resident-centered professional committed to supporting the psychosocial well-being of older adults. You build trusting relationships with residents and families, advocate for their needs, and help them adjust to life within the community. You are organized, detail-driven, and confident in navigating regulatory requirements, care planning, behavioral support, and discharge processes. You communicate clearly, collaborate naturally with interdisciplinary teams, and maintain a calm, solutions-focused approach when challenges arise.

As a Social Worker, you will coordinate, develop, and maintain individualized plans of care that support each resident’s psychosocial health and rights. You will serve as the primary social services contact for your assigned caseload and ensure compliance with federal, state, and facility standards.

• Serve as the designated social worker for an assigned portion of the resident population.
• Support residents in adjusting to life in the nursing facility, engaging in activities of choice, and overcoming barriers to socialization and daily living.
• Identify, communicate, and help resolve resident and family concerns, collaborating with the Director of Social Services, Administrator, and other department leaders.
• Educate residents about their rights and assist them in exercising those rights appropriately.

• Complete social histories, scheduled assessments, assigned MDS sections, and individualized care plans.
• Maintain timely, accurate progress notes and evaluation documentation that meet all state and federal requirements.
• Actively participate in the care planning process by scheduling and facilitating care plan meetings upon admission, quarterly, and as needed.
• Monitor and document resident behaviors, collaborating with staff to develop effective behavior management plans that reduce adverse outcomes.

• Coordinate relocation and discharge planning, ensuring smooth transitions and appropriate communication.
• Arrange or refer residents to outside resources such as mental health services, prescription assistance, home care, hospice, financial planning, utility services, funeral planning, and other community supports.
• Manage precertification responsibilities during skilled stays, including insurance authorizations, submission of clinical documentation, tracking updates, and follow‑up communication.
• Serve as a backup to the Director of Social Services by attending meetings, completing documentation, and providing coverage for their caseload as needed.
• Assist the marketing and admissions team as a backup to the Admissions Coordinator by handling initial inquiries, tours, and explanation of financial and administrative policies.
• Represent the organization professionally through positive public relations with residents, families, community partners, hospitals, and agencies.
• Participate in marketing meetings and events as needed.

Education & Certification: Bachelor’s degree required. Social work license/certification or designation preferred.

Experience: Minimum of two (2) years of experience working with residents in a long‑term care or related healthcare setting.

• Demonstrated ability to build positive, supportive relationships with residents, families, and team members.
• Proficiency in Microsoft Word, Excel, and PowerPoint.
• Solid understanding of long‑term care regulations and social services requirements.
• Strong ability to plan, coordinate, and implement comprehensive psychosocial care.
• Excellent communication skills, including verbal, written, and interpersonal abilities.
• Ability to communicate effectively in English.
• Proven ability to work collaboratively within an interdisciplinary, mission‑driven team.

• Enjoy a paid day off for your birthday every year - because you deserve it!
• Receive holiday double pay when working any of our 14 recognized holidays.
• Earn up to 17 days of PTO in your first year - with more as you grow.
• Shift differentials are available to reward your hard work during evenings, nights, and weekends.
• Access medical, dental, and vision insurance - starting within just 30 days.
• Life insurance and short-term disability coverage to protect you and your family.
• Employee Assistance Program (EAP) for confidential support when you need it most.

• Take advantage of education assistance, including our Achieve Your Degree program (in partnership with Ivy Tech).
• Plan ahead with a 403(b)-retirement savings plan, complete with employer match.

* Benefits listed above are eligible based upon position status & hours worked.

Equal Opportunity Employer
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