Social Worker; Mental Health Counselor - Baystate Health

Req#: R20973
Category(s): Behavioral Health, Social Worker; Mental Health Counselor
Full Time / Part Time: Full-Time
Shift: First

Clinic Overview

The Baystate Memory Assessment and Care Clinic serves people living with dementia and their families across Western Massachusetts. 

We offer memory assessment as well as ongoing management once a diagnosis of dementia has been established.  

Our goal is to provide compassionate, high-quality care to enhance the wellbeing of people living with dementia and their families from initial assessment and diagnosis through the stages of disease progression.  

We are a multi-disciplinary team including a Geriatrician, Geriatric Nurse Practitioner, Geriatric Pharmacist, Patient Services Representative, and Social Worker. We also collaborate closely with our colleagues in Psychiatry, Neuropsychology, and Neurology. 

Job Responsibilities of the Social Worker May Include

  • Participate in the initial assessment visit with the provider (NP or MD). 

  • Perform psycho-social needs assessments for all patients and families during intake.  

  • Triage patients and families based on acuity and needs, and provide appropriate and timely follow-up. 

  • Provide community resource referrals. 

  • Provide counseling, support and education to patients and their families after diagnosis.  

  • Engage patients and families in Advance Care and future care planning discussions.  

  • Participate in weekly case discussions and bi-weekly interdisciplinary team meetings.  

  • Navigate complex legal, social, and family dynamics. 

Required Education: Masters Social Work

Licensure: LCSW or LICSW

Required Work Experience:  Minimum one year as a practicing social worker in a health care or social service setting required.  Equivalent experience in a Master’s level health care setting internship may be considered.

Preferred Work Experience:  Equivalent experience with memory assessments and dementia care setting; internship experience will be considered. Spanish, Bilingual language skills are optional.

Schedule: Full-time 40-hours Monday-Friday

Additional Responsibilities May Include:

1)  Provides Social Work assessment and counseling skills and refers patients to resources such as home-based services, educational support, housing, advocacy, welfare assistance, and other services.  Demonstrates skilled assessment and knowledge about human behavior and theory including the psychosocial adjustment to illness and treatment impacting a patient as it relates to age-specific needs, stages of growth and development and coping with illness and other life stressors.

2)  As part of the assessment, evaluates the patient and family's support system, economic status, and any immediate needs in order to help patients and families access community resources for mental health, financial (entitlement programs), housing, insurance, and transportation services. Assesses the risk of abuse/neglect for children, disabled adults and/or elders as appropriate.  File reports with appropriate agencies as needed  Works as a responsible advocate for the patient's and family's concrete needs and services. Serves as a liaison with community resources on behalf of the patient. 

3)  Conducts interviews with patients and their families/support persons to assess and identify issues and help patients and families adjust to their situations through a range of focused social work interventions.

4)  Coordinates input from all health care professionals, patient and family members to formulate a documented plan of care assuring continuity of care on a daily basis. 

5)  Provides clinical consultation as an active member of the interdisciplinary care team regarding psychosocial issues, bio-ethical issues, barriers to care and other issues affecting patients and their families.

6)  Supports the mission and philosophy of the department as well as the Operating and Service Standards of Baystate Health. 

7)  Utilizes the dynamics of the health care delivery network to foster the best use of resources, effective service delivery, and patient and family satisfaction.  Coordinates with inpatient social workers as needed

8)  Plans and coordinates patient care conferences including follow-up interventions between the medical team and family as needed.

9) Enters data and information into the electronic medical record and other electronic systems in order to maintain accurate clinical records for patients and ensure an integrated approach to care.   Prepares reports timely, maintains accurate records for legal action. Refers patients to appropriate community resources including domestic violence referrals. Works in partnership with the care team coordinating referrals and follows-up on care coordination to assure timely interactions and access of services.

10) Develops and maintains working relationships with community agencies. Attends meetings with other members of the health care team, and networks in the community to enhance the care coordination of patients, locally and statewide.  Disseminates meeting minutes and updates leadership, staff, and the team regarding information and changes.

11) Demonstrates a positive attitude and professional work behaviors while serving as an advocate and role model on behalf of Baystate Health.  Exemplifies the values, ethics and specialized skill base of the Social Work Profession, and contributes these to the interdisciplinary care of patients.

12) Performs other job-related duties as assigned by the Practice/Department Manager or Senior Leadership and in cooperation with BH Case Management/Social Services departments. 

13) Seeks consultation and supervision from LICSW colleagues as needed and appropriate.

Skills and Competencies:  Knowledge of local community services, local community resources, state, and federal programs that provide medical care and financial support to children and families.  Ability to work independently and amicably in group situations.  Demonstrated ability to be a team player.  Excellent verbal and written communication skills in English.  Ability to work with diverse patient and staff populations.  Proficient in basic computer skills and Microsoft Office. Ability to navigate and document in clinical computerized patient care records. 

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.



Master of Science: Social Work (Required)


Licensed Independent Clinical Social Worker – State of Massachusetts

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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