Social Determinants of Health Lead

Overview

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.

Job Summary

Position Title: SOHD Lead/ Licensed Master Social Worker preferred

Reporting to: House Calls Division (Social Determinants of Health Dept)

Job Summary: The SOHD Lead will provide in-home social work services to individuals who are managing chronic illness, recovering from surgery, or dealing with other life-limiting conditions. This role will involve collaborating with medical teams, supporting patient and family needs, and advocating for resources to improve patient outcomes and quality of life. 

This person will be responsible to perform daily social work operations in office and on the field for House Calls. Driver will be provided 

Responsibilities

• Develop and lead an SDOH program for House Calls 

• Train and oversee Community Health Workers  

• Collaborate with physicians, nurses, and other health professionals to create a holistic care plan. 

• Connect clients with community resources such as housing assistance, healthcare services, and food programs. 

• Provide individual and family counseling to patients dealing with chronic illness, mental health issues, or the challenges of aging. 

• Offer emotional support to patients and families, addressing mental health needs and adjustment to medical conditions or lifestyle changes. 

• Provide education to clients and their caregivers on managing health conditions and navigating available support systems. 

• Participate in multidisciplinary team meetings to discuss patient progress, concerns, and adjustments to the care plan. 

• Offer insights regarding the psychosocial aspects of the patient's care, contributing to a holistic treatment approach. 

• Maintain accurate and timely documentation of patient assessments, care plans, and progress notes in compliance with organizational policies and healthcare regulations. 

• Ensure all documentation is aligned with privacy regulations (HIPAA) and other relevant guidelines. 

Qualifications

• Education: Master's Degree in Social Work from an accredited institution. 

• Licensure: Active Licensed Master Social Worker (LMSW) license in New York State. 

• Experience: Experience in behavioral health, social work, or related fields is often preferred.  

• 2-5 years experience managing a team 

• Skills: Strong communication and interpersonal skills, ability to work independently, and proficiency in electronic health records. 

• Transportation: Driver will be provided  

• Bilingual Abilities: Proficiency in additional languages, such as Spanish, may be preferred. 

Equal Opportunity Employer

ESSEN HEALTH CARE IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER

Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

Compensation: 65000 to 70000 (USD)