Social Work Case Manager

Join BoldAge PACE and Make a Difference!

Why work with us? • A People First Environment

Competitive Compensation

• Medical/Dental
• Generous Paid Time Off
• 401K with Match
• Life Insurance
• Tuition Reimbursement
• Flexible Spending Account
• Employee Assistance Program

Be part of our mission!

Are you passionate about helping older adults live meaningful, independent lives at home with grace and dignity? BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of our participants. Our approach is simple: We listen to our participants and their caregivers to truly understand their needs and desires.

Social Work Case Manager

SUMMARY

The Social Work Case Manager is responsible for providing comprehensive care coordination, advocacy, and support to program participants and their families. This role involves assessing participants' social, emotional, and environmental needs, developing individualized care plans, and connecting participants to community resources and services. The Social Work Case Manager collaborates closely with the interdisciplinary team (IDT) to ensure participants' care plans address their holistic needs, promote independence, and enhance their quality of life. This position requires strong organizational, communication, and problem-solving skills, as well as a commitment to delivering participant-centered, high-quality care.

Essesntial duties and responsibilities

• Support the implementation of participants’ care plans and act as a liaison between participants, caregivers, community agencies, and the interdisciplinary team (IDT).
• Coordinate participant admissions and discharges to healthcare facilities, temporary respites, or permanent placements, including referrals to housing options and accompanying participants as needed.
• Provide education and ongoing support to participants and families regarding PACE services, resources, and benefits, including Social Security, Medicaid, and Medicare applications and renewals.
• Assist participants in maintaining housing and independence through interventions, home visits, and collaboration with caregivers and housing providers.
• Offer guidance to team members on topics like dementia, behavioral challenges, and care strategies.
• Manage documentation of clinical services, including placements, hospital admissions/discharges, home visits, and significant events, adhering to PACE requirements.
• Assist participants and caregivers with grievances, appeals, and maintaining Medicaid eligibility.
• Facilitate transitional care in the event of program termination, ensuring continuity of services and referrals to other providers.
• Provide case management services and coordinate appointments between social service staff and participants.
• Perform administrative tasks such as filing, scanning, faxing, and mailing documents.
• Follow organizational policies, safety guidelines, and confidentiality standards to maintain a safe and compliant work environment.
• Participate in Quality Improvement initiatives, continuing education, training, and maintaining professional certifications.

Experience education and certifications

• Bachelor's degree in social work or related field
• Experience working on an interdisciplinary team in a hospital, nursing home or community-based setting is preferable.
• 1 year of experience working with a frail or elderly population preferred. If this is not present, training will be provided upon hiring (If applicable for the role).

Pre-Employment requirements

• All Employees - Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance.
• Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.

• BoldAge PACE provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
• Match begins after one year of employment

Days

• Monday through
• Friday, with occasional weekend coverage
• Days: Monday through Friday, with occasional weekend coverage