Preferred Primary Care Physicians is currently recruiting for a full-time Medical Social Worker to join the PPCP Case Management team. This is a mostly remote position with some on site work required.

General Purpose of the Medical Social Worker Position: The Social Worker works closely with providers, RN Care Managers, pharmacists, and other care team members to support patients in connecting, acquiring and using any and all resources necessary to promote and protect their medical and psychological wellbeing.

Essential Duties and Responsibilities:•Understands and incorporates principles and procedures of Chronic Care Management per guidelines developed and approved by Preferred Primary Care Physicians in the provision of needed services.

•In collaboration with the Primary Care Provider, identifies patients eligible for services.

•Meets with eligible patient and completes a comprehensive psychosocial assessment of needs for services including all appropriate needs for medical follow up, psychological assistance, housing, transportation, financial and nutritional support.

•Provides educational information, including written guidelines on types of needed services and eligibility.

•Develop a comprehensive written care plan for all needed services. In discussion with the patient, develop action steps including priorities sharing practical information about each step that is explained in a matter that is understood by the patient.

•Working with the Primary Care Physician, provide the non face-to-face services required by the patient that fall within the scope of the MSW.•

Coordinate appropriate care among all providers.

•Ensures continuity of care through defined, evidence -based methods, including follow up to insure the action plan is being implemented as documented utilizing resources in a patient-centered and efficient manner. Promotes and facilitates improved clinical outcomes and patient satisfaction.

•Document services provided in the patient's chart.

•Utilize ENLI Care Manager to track patients, care needed and provided.

•Attends IDC meetings with appropriate office staff and the patient's care team for patients utilizing the services of the MSW

•Monitor program effectiveness at the point of care (e.g. physician offices) and provide feedback and training to office staff and physicians.Job Responsibilities:•Identify appropriate patients and educate regarding Chronic Care Management program. Enroll appropriate patients.•Performs complete assessment of patient's current needs, including barriers to achieving optimal health and patient's available resources and gaps•Based on assessment and in conjunction with patient/family/caregiver, provider and other health care team members, participates in the development of the Plan of Care and Self-Management Plan that highlight actual and potential opportunities for improving clinical•Coordinate and make referrals to the appropriate community resources•Educate office staff on program to assist in identification and support of appropriate patients.•Provide non face-to-face services as required by the patient. Track services.•Coordinate patient care among providers.•Maintain a database of available Community Resources for all staff.

Education:Master's Degree in Social Work

Experience/On the Job Training:Minimum 3 years minimum. 2 years in healthcare related field preferred.

About Us:

At Preferred Primary Care Physicians, preferred health care is simply our standard. Our practice was established in 1995 when a group of dedicated physicians in the South Hills came together for one common purpose: to provide the highest quality care to their patients. Their ingenuity and expertise laid the foundation for our independently owned practice, which now operates out of more than 20 locations in the greater Pittsburgh area. Our elevated level of service is supported by our team-based approach, comprehensive clinical programs, and state-of-the-art outpatient centers. From providing general primary care to managing chronic conditions, we give all of our patients the preferential treatment they deserve.

Come join the team and enjoy a very competitive employee benefit package including medical, dental, vision, company paid life insurance, and 401k with competitive match.

Please visit our website www.ppcp.org for more info about our company.

EOE