Home Health Medical Social Worker (MSW)

Skilled Clinicians Minneapolis/ St. Paul, Minnesota


Position at Lifespark

The Medical Social Worker is primarily responsible for the implementation of standards of care for medical social work services and as defined by the state Medical Social Work Practice Act.  Secondarily, assist with the execution of navigation services to assist referrals with navigating the healthcare system, converting the referral to a consultation or start of care, and generating revenue.  Specific responsibilities include but are not limited to: referral management, support of care management and skilled service team activities, and Guidance program management.

Position Functions and Responsibilities

Client Care & Service Delivery

  • Performs accurate and comprehensive assessments.
  • Obtains physician orders for certification and recertification of home medical social work services.
  • Coordinates care planning and delivery with the physician, client/family, other healthcare team members and HHA staff to facilitate optimal patient outcomes.
  • Delivers medical social work modalities and interventions appropriate to the client’s clinical status and needs, and in accordance with the standard of care for client’s age.
  • Provides, modifies or discontinues medical social work modalities and interventions based upon an ongoing assessment/reassessment of the client’s clinical status and in accordance with physician orders.
  • Synthesizes assessment data and analyzes data to make clinical judgments regarding client management.
  • Provides medical social work modalities in an environment that optimizes client safety and reduces the likelihood of medical/health care errors.
  • Completes ACP (advanced care planning) as requested

Visits, Communication, and Customer Service

  • Ensures that changes in clients’ clinical status are communicated to other healthcare team members and HHA office staff verbally and in writing in a timely manner.
  • Ensures that physician orders are communicated to other healthcare team members and HHA staff in a timely, accurate, and thorough manner.
  • Educates client/family and other staff as appropriate, in appropriate medical social work modalities and interventions
  • Honors client confidentiality, rights, privacy, and reporting maltreatment expectations.


  • Follow all Emergency and Response Procedures
  • Identifies home safety issues and notifies RN Case Manager or Clinical Manager of concerns or issues
  • Supports and maintains a culture of safety and quality.
  • Injury – Now What? Follows protocols

Event Management Reporting

  • Overview of Process, Types of Reports and Forms
  • Follow-up Required – Escalating Event

Other duties as assigned



  • Minimum of one year of experience in health care.
  • Experience in a home health care setting preferred.


  • Graduate of a Master's program in social work accredited by the Council on Social Work Education.
  • Current and active Medical Social Worker license in the state of Minnesota.
  • Possess and maintain valid CPR certification

Knowledge / Skills

  • Experience using technology including: Microsoft Office, Smart Phone, Calendaring, Clinical Software platforms (EMR), Wi-Fi, Printers, and Internet Browsing
  • Ability to follow written instructions and type a minimum of 20 words a minute.


It has been and will continue to be our policy to provide equal employment opportunities to all employees and applicants without regard to race, color, creed, religion, sex, gender identity, pregnancy, national origin, citizenship, marital status, familial status, age, sexual orientation, veteran status, disability, public assistance status, genetic information or any other status protected by federal, state or local law.