Social Worker, Community Health

Overview

Company Mission
Duo Health is a new type of medical group designed around the needs of patients with chronic kidney disease and their physicians. Our unique Health Mobilization™ platform partners multidisciplinary care teams with community nephrologists and activates all the other clinicians, facilities and community organizations necessary to treat the whole patient on their own terms. Our team is comprised of leaders in value-based health care, technology and behavioral science who share a vision for advancing health equity one relationship at a time.

Our interprofessional care teams, which include physicians, nurses, social workers, and patient navigators, provide high-touch and comprehensive care to a small panel of patients. Team collaboration is essential to our intensive, psycho-social model of care which includes assessment, medication management, social management, and behavioral health management. Duo Health is dedicated to ensuring our staff reflects the diversity of our patient population and applicants whose work demonstrates a commitment to issues of diversity are encouraged to apply.

The Social Worker is an ideal position for a proactive, self-motivated, positive individual who will work closely with the interprofessional care team to coordinate patient care and improve patient outcomes. This is a 50% field-based 50% remote role, focusing on care management for a small panel of high-risk patients.

• Serve as the primary social work contact for a designated panel of patients, conducting comprehensive social assessments on high-risk patients.
• Collaborate with care teams to provide psychosocial interventions and case management services to a patient panel oh high-risk patients.
• Provide end-of-life care support with sensitivity and empathy.
• Deliver longitudinal care management for designated panel of high-risk patients
• Build and maintain strong relationships with patients to foster trust and effective care planning.
• Identify and address barriers to care through SDoH referrals and community resources.

• Master’s degree in social work (MSW) or Licensed Clinical Social Worker (LCSW) in the state of Florida
• High level of clinical and case management expertise.
• Must meet Duo Health requirements for care team staff, including passing a background check and drug screen and meeting COVID-19 vaccine requirements.
• Reliable transportation and a verifiable good driving record. Must be able to travel to patient homes.
• Must be self-motivated and able to perform work in accordance with defined operating procedures.
• Ability to develop and maintain inclusive and equitable relationships with patients, caregivers and staff
• Experience working with community resources from diverse backgrounds
• Priority will be given to candidates who live in the communities we serve and whose life experience reflects that of our patient population
• Ability to communicate effectively both orally and in writing.
• Must be comfortable interacting with patients and care teams both telephonically and in-person.

• Competitive Benefits Package
• Comprehensive medical, dental, and vision plans.
• Generous paid maternity and paternity leave.
• 401(k) plan with company matching.
• 4 weeks of PTO and 12 paid holidays.
• Access to free wellness & personal development courses.

• Work with a patient-focused team dedicated to improving health outcomes and advancing health equity through innovative care models.