Social Services - LCSW (Licensed Clinical Social Worker)
Social Services - LCSW (Licensed Clinical Social Worker)
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Job Description
Title: Case Manager MSW
Department: Social Worker
Type: 13-Week Travel Contract
Schedule: Day Shift 5x8-Hour (08:00 16:30) Monday to Friday No weekends or on-call
Start Date: 08/18/2025
Summary:
We are seeking a Masters of Social Work (MSW) Case Manager to support its community clinic-based PACE program. This role focuses on comprehensive case management and care coordination for high-risk patient populations across the continuum of care. The Case Manager will work closely with the Interdisciplinary Team (IDT) hospital discharge planners skilled nursing facilities (SNFs) and community resources to ensure safe appropriate discharges and continuity of care. The position requires prior travel experience and strong proficiency in Epic and complex psychosocial assessments.
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Conduct initial and 180-day reassessments for assigned panel participants
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Collaborate with hospital discharge planners to implement IDT-recommended plans for safe discharges
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Coordinate transitions to/from SNFs and community settings for participants with skilled or rehab needs
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Perform detailed biopsychosocial assessments and develop patient-centered care plans
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Facilitate access to community programs (Medicaid Medicare HCBS Social Security etc.)
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Participate in care conferences and team huddles as part of the PACE IDT
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Address issues related to protective services advanced directives and guardianship
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Provide crisis intervention short-term counseling and discharge planning
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Document patient interactions education and outcomes in Epic EMR
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Experienced travelers only first-time travelers not accepted
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Must have prior community hospital experience
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Epic proficiency required
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Must be available full-time Monday to Friday
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Strong understanding of post-acute care care coordination and long-term support services
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Patient caseloads average 1:50 ratio
Education:
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Masters Degree in Social Work (MSW) required
Experience:
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Minimum 2 years of clinical or case management experience in community or acute settings
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Travel experience required
License/Certifications:
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MSW required
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LCSW or LMSW preferred
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BLS required
Care Coordination & Case Management:
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Discharge planning SNF rehab transitions plan of care benefits eligibility authorizations
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Interdisciplinary collaboration referrals to community and rehab services
Clinical Assessment & Patient Support:
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Biopsychosocial assessment dementia screening response-to-treatment analysis
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Advance directives high-risk intervention suicide/self-harm identification
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Protective services emergency detention POA guardianship
Documentation & Communication:
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EPIC documentation (required) discharge summaries progress notes goal setting
Counseling & Therapy:
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Short-term therapy crisis intervention education long-range planning
Community Program Knowledge:
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HCBS Medicaid Medicare Medicare waiver programs Agency on Aging
Special Populations:
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Geriatric dementia psychiatric conditions vulnerable/high-risk patients
Settings Experience:
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Outpatient clinics LTC/Nursing homes Rehab Emergency Dept ICU Psychiatric units
ATD Technology LLC is a certified minority woman owned business that creates opportunities to match qualified individuals with client programs while meeting all parties financial and technical goals. ATD is a full service provider with offerings in Contract Permanent and Temp-to-Perm staffing solutions. We serve Fortune 1000 mid cap and small cap companies in the Commercial Public and Government sectors.
Employment Type
Full-time
