About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto — "Better. Together.” — is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community’s health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County’s best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About the Position

The Social Worker (PACE) will be responsible for direct social work care management services, such as participant screening, case management, counseling and referrals of participants to CalOptima Health’s Program of All-Inclusive Care for the Elderly (PACE).

Duties & Responsibilities:

• Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
• Participates in the Interdisciplinary Team’s (IDT) initial, six (6) month and annual assessments, as well as care planning of the participant's case in accordance with industry and departmental standards.
• Documents participant changes appropriately in the medical record in accordance with industry and departmental standards.
• Communicates effectively and openly with other IDT members on participant status and needs.
• Assesses patients for high-risk situations such as suicidal/homicidal ideation and abuse. Reports appropriately in accordance with legal and ethical standards of practice and engages in safety planning with participant and/or family.
• Develops and leads group counseling and participant support group activities.
• Refers participants and families to appropriate community agencies or facilities, serves as a liaison with such organizations and as an advocate for participants.
• Assists in the completion of advance directives, mortuary arrangements, funeral planning and/or facility placement.
• Provides assistance to patients/representatives in ascertaining third-party and financial resources and planning for financial coverage for services as necessary.
• Consults with and advises staff members in regards to the relationship of social, emotional and cultural factors to health and medical care and the availability of social services in the community.
• Attends and participates in in-services, staff meetings and case conferences.
• Helps support the new enrollee process of enrollment into the PACE program (e.g., communicates to IDT and ensures all gaps of service are covered prior to enrollment).
• Addressess any psychosocial needs that may require social work support and intervention (e.g., anxiety, depression and other behaviors), both at the center and at home.
• Works with PACE participants and the IDT in developing an appropriate discharge plan for disenrolling from PACE services.
• Participates in program improvement for the Social Work department.
• Works with the Quality Improvement (QI) department to support grievances, appeals and advocacy consistent with participant’s rights.
• May be required to perform home visits to private homes of CalOptima Health’s PACE participants; frequent travel in Orange County.
• Completes other projects and duties as assigned.

Experience & Education:

• Master’s degree in Social Work (MSW) from an accredited college or university required.
• 2 years of experience in a health-related field required.
• 1 year of experience working with the elderly population with relevant experience within the last 3 years required.
• Valid driver’s license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 30% of the time or more.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
• Current CPR and First Aid certification required or the ability to obtain it within the first six (6) months of employment.

Preferred Qualifications:

• 1 year of case management experience with the elderly population.
• Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Work Environment: Employee must be able to work effectively within an interdisciplinary team model, interfacing and collaborating with a wide range of clinical and social services disciplines who work together to manage the PACE member’s care. The work setting is in an Adult Day Health Center and primary care clinic environment with moderate noise levels and controlled office temperatures.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima wants to have qualified employees in every job position. CalOptima prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. You can request reasonable accommodations by contacting Human Resources Disability Management at 657-900-1134.