The social worker will primarily function as one of our GUIDE Care Navigators and acts as the primary point of contact between eligible patients living with dementia, their caregivers (referred to as the dyad), and the care team at the Geriatric Assessment Center and AHS.
*This is a hybrid position that would also require the team member to preform home visits*
Principal Accountabilities:
(1). Provide eligible patients and families with a screening assessment and educate them about the GUIDE model and its components.
(2). Participate in completion of the enrollment documents and submission of all information on the information portal at the time of enrollment and on an ongoing basis as delineated by CMS.
(3) Provide dementia-specific education and support to the patient and family, and help families learn what to expect in the future.
(4) Routinely perform home visits and virtual visits to screen dyads for unmet care needs (including clinical and medication issues), behavioral issues, safety risks, and psychosocial well-being.
(3). Work closely with the GUIDE Program Manager and the GAC clinical team to address care needs and coordinate respite referrals.
(4). Connect dyads to local community services, including respite care.
(5). Collect information about medications and medication adherence, present this information to the care team, assist in medication reconciliation, and help implement strategies to improve medication adherence.
(6). Work with both the care team and the dyad to assess medication side effects and changes in function and behavior.
(7). Routinely collaborate with the GUIDE Program Manager to address more complex medical or psychosocial issues.
At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:
We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:
Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:
Team Member Benefits
____________________________________________
Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran