Medical Social Worker (Long Term Service Support Coordinator)

Location: Lakewood, WA
Date Posted: 08-20-2017


Are you a Medical Social Worker that loves being in a team environment who enjoys partnering with the Care Coordinator (RN) to advocate and coordinate the continuum of care for our patients?
Do you love to support your patients in achieving their own goals as described in their care plan and monitor adherence to treatment plans or other disease/chronic condition management programs?
Do you have a strong desire to build close relationships all members of your team and committed to working collaboratively to provide excellent care for patients?
Do you love the idea of a dynamic, field based position, conducting assessments, coordinating community resources and maintaining care giver care plans?
You will provide a high standard of interaction with our patients to:
  • Perform effective outreach to complete necessary health and social assessment
  • Engage them in the development of an integrated, patient-centered care plan that takes into account needs across the continuum of care
  • Work with a multi-disciplinary care team to develop interventions and changes to the care plan in response to patient’s needs and promotes positive health outcomes.


  • Participating in outreach and engagement strategies with a select group of high-utilizers and at-risk patients
  • Identifying patient goals and barriers to those goals; addressing these issues with the patient and their surrogate decision makers
  • Providing brief, focused social work interventions in collaboration with a multi-disciplinary care team
  • Evaluating crisis situations and employing appropriate interventions
  • Improving population health outcomes by ensuring all patients and primary care team members have access to social support resources
  • Assisting with navigation of social and health care systems
  • Facilitating and overseeing referrals to community resources
  • Providing education and consultation to providers and other team members on addressing the social needs of patients
  • Assisting with patient education in various forms (i.e. individual coaching; group classes)
  • Attend scheduled multi-disciplinary team meetings and provide relevant recommendations to improve the health of high-risk patients and those who have recently been hospitalized
  • Travel between care center locations may be required (Lynnwood, Renton, and Lakewood Care Centers)
  • Performing other duties as assigned.


  • Must be Licensed Independent Clinical Social Worker, to practice independently in the State of Washington; Or LSWAIC with expected LICSW within 2 years.
  • Must have a master’s degree in Social Work.
  • Competency in motivational interviewing preferred
  • Experience working in integrated medical settings preferred
  • Exceptional capacity to multitask
  • Must be flexible and comfortable with ambiguity
  • Excited to think about addressing social barriers to health in a new way and in a team setting
  • Experience and/or ability to work with electronic health record systems
  • Average to advanced computer & software skills (Microsoft Word, Excel, Outlook)
  • Excellent communication and customer service skills
  • Ability and means to travel as needed in a timely manner within King, Pierce and Snohomish Counties, to locations that may have limited access to public transportation; proof of liability and property damage insurance on vehicle used is required. DRIVER REQUIREMENTS: Age 21; Licensed for a minimum of 3 years; No violations and/or accidents within 3 years; No vehicle-related suspensions/reinstatements; No DUI, reckless or felony Driving with 7 years.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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