Self-Help for the Elderly·San Francisco, California
The Medical Social Worker assesses the social and psychological needs of patients and families, developing care plans to address these needs. They also maintain clinical records, provide information and referral services, and collaborate with healthcare teams to support patient care.
Title: Medical Social Worker
Department: Home Care & Hospice
FLSA Status: Non-exempt
Reports To: Director of Patient Care Services
Assesses social and psychological needs of patients/families, and develops plan of care to assist patients and families/caregivers to cope with the social and emotional issues and practical arrangements related to the patient’s illness. The Medical Social Worker is responsible for the implementation of standards of care for medical social work services.
⦁ Assesses the psychosocial status of patients related to the patient’s illness and environment and communicates findings to the registered nurse.
⦁ Carries out social evaluations and plans interventions based on evaluation findings.
⦁ Maintains clinical records on all patients referred to social work.
⦁ Provides information and referral services for organization patients and families/caregivers regarding practical and environmental needs.
⦁ Provides information to patients or families/caregivers and community agencies.
⦁ Serves as liaison between patients or families/caregivers and community agencies.
⦁ Maintains collaborative relationships with organization personnel to support patient care.
⦁ Maintains and develops contracts with public and private agencies as resources for patient and organization personnel.
⦁ Participates in the development of the total plan of care and case conferences as required.
⦁ Assists physician and other team members in understanding significant social and emotional factors related to health problems.
⦁ Participates in discharge planning.
⦁ Participates in in-service education programs
⦁ Completes all required documentation in a timely fashion in accordance with regulations and office standards.
⦁ Other duties as delegated by the supervisors.
⦁ Assesses the psychosocial status of patients and families/caregivers related to the patient's terminal illness and environment and communicates findings to the registered nurse and other members of the interdisciplinary group. Provides an assessment in the patient's identified residence and assistance when this is not safe and another plan is required.
⦁ Carries out social evaluations, including family dynamics, caregiver abilities, communication patterns, high-risks for suicide, neglect or abuse and plans intervention based on evaluation findings. Counsels patient and family/caregivers as needed in relationship to stress, and other identified coping difficulties. Provides crisis intervention when necessary.
⦁ Assesses for, and educates interdisciplinary group, on any special needs related to the culture of the patient and family. Includes communication, role of family, space, and any special traditions or taboos.
⦁ Maintains clinical records on all patients referred to social work.
⦁ Educates patients and families on, and assists in, preparation of advanced directives.
⦁ Provides information and referral services for organization patients and families/caregivers regarding practical and environmental needs.
⦁ Provides information to patients and families/caregivers and community agencies.
⦁ Serves as liaison between patients and families/caregivers and community agencies.
⦁ Maintains collaborative relationships with organization personnel to support patient care.
⦁ Maintains and develops contracts with public and private agencies as resources for patient and personnel.
⦁ Participates in the development of the individualized plan of care, involving the patient and family, and attends regularly scheduled interdisciplinary group meetings, assisting the team in recognizing the effects of the psychosocial stresses on the symptoms of the terminal illness.
⦁ Assists physician and other team members in understanding significant social and emotional factors related to health problems and death/dying issues.
⦁ Actively participates in quality assessment performance improvement teams and activities.
⦁ Assists family and patient in planning for funeral arrangements, financial, legal, and health care decision responsibilities.
⦁ Completes all required documentation in a timely fashion in accordance with regulations and office standards.
⦁ Other duties as delegated by the supervisors.
Qualifications: ⦁ Is licensed as a clinical social worker by the Board of Behavioral Sciences; or
⦁ Has a Master of Social Work degree from a school of social work accredited by the Council on Social Work Education and has one year of social work experience in a health care setting.
Authority cited: Sections 1734 and 131200, Health and Safety Code.
Sections 1727, 1734, 131051 and 131052, Health and Safety Code.)
⦁ Minimum of one year’s experience in health care, home health care and hospice experience preferred.
⦁ Understands hospice philosophy, and issues of death/dying.
⦁ Knowledge of chronic and acute disease and how it affects patient and family functioning. Knowledge of community resources and understanding of the influence of culture on health care.
⦁ Comfortable working with families in crisis, the frail elderly, the disabled and the terminally ill.
⦁ Ability to work both independently and collaboratively as part of an interdisciplinary team.
⦁ Ability to engage and work collaboratively and harmoniously with others, including patients, patients’ families clinical team members, and community resources/partners.
⦁ Demonstrates good verbal and written communication, and organization skills.
⦁ Knowledge of MS Office and the Internet, and knowledge of/ability to learn and proficiently use electronic health records software.
⦁ Possesses and maintains current CPR Certification.
⦁ Must pass health screening for TB clearance, physical examination, and background check.
⦁ Bilingual in English and Cantonese. Mandarin & Toishanese are a plus.
Must be able to travel via public transportation or personal/department vehicle for the performance of job duties. If driving, must have and maintain a valid CA driver license, satisfactory driving record, and auto insurance coverage as specified in Self-Help's policy.
Self-Help for the Elderly is an Equal Employment Opportunity/Affirmation Action Employer and we welcome diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, age, national origin, sexual orientation, disability, protected veteran status or any other characteristics protected by law. We participate in E-Verify.
Qualified applicants with criminal history will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.
We may provide reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please call (415) 677-7600 for special assistance.
Candidates must be licensed as a clinical social worker or have a Master of Social Work degree with relevant experience. Knowledge of hospice philosophy, chronic and acute diseases, and community resources is essential.
Market context
California healthcare employers often look for medical social workers who can support discharge planning, coordinate community resources, and work across hospital or outpatient settings. These roles are competitive because they typically require a CSWE-accredited social work degree, healthcare experience, CPR certification, and reliable transportation for field-based duties. Review the AI-summarized requirements and benefits on this platform against the original posting, then confirm your licensure, driving documents, and healthcare experience before applying.
