Full-Time

Licensed Medical Social Worker

Optimal Care

Optimal Care

51-200 employees

Medicare-certified home health with geriatric care

No salary listed

Grand Rapids, MI, USA

In Person

Daily home visits within the Grand Rapids, MI service area; occasional on-site office meetings.

Master's, PhD

Category
Medical, Clinical & Veterinary (1)

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Requirements
  • Master's or doctoral degree from a CSWE-accredited school of social work
  • Current State License as a Master's Social Worker (MSW/LMSW/LCSW)
  • Minimum 1 year of experience as a licensed Master's Social Worker
  • Reliable transportation with valid automobile insurance
  • Willingness to travel daily for home visits within service area
  • Strong clinical assessment and counseling skills
  • Ability to identify and address social determinants of health
  • Knowledge of community resources and social service systems
  • Excellent communication and patient education abilities
  • Skill in navigating complex family dynamics and emotional stress
  • Cultural sensitivity and tolerance for diverse lifestyles
  • Strong time management and organizational skills
  • Ability to work independently while collaborating with multidisciplinary teams
  • Understanding of how psychosocial factors impact medical recovery
Responsibilities
  • Assess and Address Psychosocial Needs: Complete initial social work evaluations within 5 days of start of care
  • Assess social and emotional factors affecting patients' ability to follow medical recommendations
  • Re-evaluate psychosocial needs during follow-up visits to track progress
  • Help patients and families cope with problems in daily living that impact health
  • Identify barriers to recovery and develop strategies to overcome them
  • Counsel and Educate: Provide counseling to facilitate adherence to medical treatment plans
  • Teach and promote healthy lifestyles and psychosocial wellness
  • Help patients understand how social and emotional factors impact their health
  • Support families in understanding and implementing care plans
  • Work toward patient and caregiver independence as the ultimate goal
  • Connect Patients with Resources: Identify and utilize community and family resources to support long-term plans
  • Help patients learn to live within their disability or manage chronic conditions
  • Address personal, financial, and environmental difficulties affecting health
  • Provide information about community agencies and support services
  • Coordinate resources that enable patients to remain safely in the community
  • Collaborate on Care Planning: Develop individualized social work care plans with case managers, physicians, patients, and families
  • Set appropriate, measurable goals that address psychosocial barriers to health
  • Participate in multidisciplinary care conferences for complex cases
  • Initiate care conferences when needed to ensure coordination
  • Contribute to discharge planning to support long-term success
  • Help the healthcare team understand significance of social and emotional factors in recovery
  • Maintain Clinical Excellence: Complete accurate, timely documentation and weekly activity logs
  • Maintain current knowledge of Medicare Conditions of Participation for social work services
  • Participate in quality improvement initiatives
  • Stay current with social work trends and evidence-based practices
  • Ensure clinical notes reflect ongoing communication with team members
Desired Qualifications
  • Previous home health or medical social work experience
  • Knowledge of Medicare home health benefit and Conditions of Participation
  • Experience with care coordination and discharge planning

Optimal Care provides Medicare-certified home health services for seniors, guided by a nurse practitioner-led care model. A nurse practitioner visits patients at home and develops individualized care plans that cover behavioral health, dementia, geriatric, diabetic, wound, and orthopedic care. This in-home, NP-driven approach offers a broad suite of geriatric-focused programs rather than only post-surgical or rehabilitation services. Its goal is to keep seniors safe and healthy at home by coordinating comprehensive, specialty care in their living environments.

Company Size

51-200

Company Stage

N/A

Total Funding

N/A

Headquarters

Michigan

Founded

2003

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Simplify Jobs

Simplify's Take

What believers are saying

  • June 2026 job postings show active hiring across Jackson, Grand Rapids, Saginaw, and Wayne.
  • Optimal Care launched a consolidated brand after the June 2025 union, simplifying sales.
  • Employee recognition and mileage, PTO, and sign-on bonuses support retention and referral growth.

What critics are saying

  • Michigan reimbursement pressure and staffing shortages squeeze margins across home health and hospice.
  • The 2025 merger integration can disrupt referrals, billing, and culture through 2026.
  • A CMS audit or wage-class-action challenge would damage credibility and trigger existential cash strain.

What makes Optimal Care unique

  • June 2025 merger created one integrated physician, home health, and hospice platform.
  • Clinician-owned Optimal Care emphasizes coordinated post-acute care across Michigan markets.
  • Fortune named Optimal Care among 2025's 15 best workplaces in aging services.

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Benefits

Paid Time Off

Company Vehicle Program

Flexible Work Schedule

Medical, Dental, and Vision Insurance

401(k) Retirement Plan

Mileage Reimbursement

Company News

EIN News
Oct 15th, 2024
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