AIM Transitions MSW Job Listing at Sutter Care at Home in San Francisco East Bay and Solano, CA

Home Health Care, Pharmacy

On any given day, Sutter Care at Home touches the lives of thousands of individuals by bringing health care directly to patients where they live - at home.

From local, community-based offices throughout Northern California, the dedicated staff at Sutter Care at Home cares for more than 50,000 patients each year and serves an average daily census of over 18,000 patients. We provide the most comprehensive range of home care services including skilled nursing, rehabilitation therapy, home infusion therapy, hospice and palliative care, medical social work, home medical equipment and respiratory therapy, home attendant and care management, and community flu and wellness programs. Through competitive wages and benefits, flexible schedules, innovative care models, new technologies, and tuition reimbursement - Sutter Care at Home strives to be your "employer of choice." Sutter Care at Home is the home health care and hospice affiliate of Sutter Health, one of the nation's largest not-for-profit health care systems. The AIM implementation is a three-year Health Care Innovation Award funded by the Center for Medicare Medicaid Innovation. AIM is a patient-centered and evidence-based model of care for patients with advanced illness that is specifically designed to address the gaps in our current health care system that these patients routinely experience. Through this project, Sutter hopes to clearly show that AIM is a highly effective, replicable, scalable model that can be implemented nationally. AIM provides nurse-led care management, palliative care, and advance care planning for patients with late-stage chronic illness. AIM is provided at no cost to patients and their families. The expansion of AIM system-wide will provide additional services to coordinate care across the network for patients with advancing chronic illness. The Medical Social Worker provides counseling and supportive services to the patient, their family, caregivers, and SCAH staff. This position assesses the social and emotional factors related to the patient’s illness and evaluates the psychosocial response to treatment and level of adjustment. This position interprets to the family, patient, physician, and staff, the social and emotional factors related to illness, financial and community resources.