Christ Community Health Services·Memphis, Tennessee
The Social Worker reduces social barriers to health for high-risk mental health patients by connecting them to community resources and facilitating higher levels of care. They coordinate treatment between patients, primary care providers, and behavioral health clinicians to ensure seamless care delivery.
Job title: Social Worker
Department: Behavioral Health
Reports to: Social Work Clinical Team Lead
Flsa status: Non-Exempt
Created date: 2/22/2021
Revision dates: 4/1/2021, 12/10/2021, 4/2/2024
Social Workers support the Integrated Care Team by reducing social barriers to health and facilitating higher level of care for high risk mental health patients. This includes ensuring that patients have ready access to resources, as well as coordinating connection to community treatment resources. In addition, Social Workers ensure excellent treatment coordination for high risk mental health patients through hands-on clinic coordination, keeping the care delivery team well-informed by bridging communication to and from patients, PCPs, BHCs, and community behavioral health providers when necessary.
Key responsibilities
Responds to identified patient social determinants of health (SDoH) through further assessment and connection to community resources. Monitors gaps in referral connection and modifies referral accordingly
Helps support food bank deliveries, transportation to services, insurance sign-ups, and patient engagement, as needed.
Supports the psychological well-being of high risk behavioral health patients on an assigned patient caseload. Closely coordinates care with the patient’s medical provider, BHC, and other care team members for monitoring, tracking, and treatment planning
Manage high risk referral process and monitor follow-up needs, including discharge, ensuring ROI is completed for all patients in caseload for coordinating care with community providers and hospitals
Provide back up for BHCs for suicide risk assessments and disposition.
Receive, coordinate, and track referrals for mental health assessment and treatment with community mental health providers
Update patient registry within eHR for patient monitoring and reporting to care teams, clinical team leads, and Clinical Team Lead
Function as liaison with mental health and social service partners in the community to coordinate services for patients.
Works closely with care coordinators though receipt of high risk referrals and update of regular care plan.
Attends regular supervision meetings with the Social Work Lead and required staff meetings.
Bachelor’s Degree in Social Work, Behavioral Health, or related field. Master’s Degree encouraged.
Patient care and social work experiences required.
Licenses or Certifications: MSW, BSW
Level 1 – Requires some concentration and normal attention. Generally, once the job is learned, the tasks can be performed more or less automatically.
Level 2 – Requires high periods of concentration intermittently and normal attention. Generally, even once the job is learned, tasks will require normal attention to deal with recurring variables.
Level 3 – Requires a high level of concentration and high level of attention intermittently. Generally, the approach to tasks may be consistent, but the number of steps required and/or the number of variables involved creates the possibility of errors unless the incumbent pays close attention.
Activity: Approximate % of Time
Sitting: 60%
Average depending on work site
Standing: 20%
Average depending on work site
Walking: 20%
Average depending on work site
100%
Machines and Equipment Used: Machines, Equipment, Tools
Approximate % of Time
Degree of Hand: Eye Coordination Required
1. Computer
2. Telephone
3. Photocopier, fax machine
Approximate percentage of time incumbent spends in “on-the-job” travel, excluding commuting to regular work location: Little to no regular travel will be necessary
Market context
In Tennessee, social worker openings are often tied to behavioral health and care-coordination needs, so candidates with clinical training and licensure tend to stand out. This role is competitive because the employer prefers TN SW licensure, NASW membership, and mental health experience, while requiring a master’s degree plus current HWC and CPR certification. Review the AI-summarized requirements and benefits here to save time, then confirm your credentials match the posting before applying.
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