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About the Role

As a leading provider of outcomes-driven care for individuals and communities living with chronic conditions, Somatus is helping patients across the country enjoy More Healthy Days at Home™. We partner closely with health plans, health systems, and provider groups to support patients with, or at risk of developing, cardio, kidney, metabolic, or other chronic conditions. We hire the brightest and boldest — talent driven by purpose and impact.

Responsibilities

Assess, educate, and collaborate with patients on care planning addressing work, travel, financial concerns, and emotional support.
Provide psychosocial support to individuals, families, and groups coping with chronic, acute, or terminal illnesses.
Offer patient education and counseling, insurance coordination, and referrals for other services.
Provide care and case management, or interventions to promote health, prevent disease, and address healthcare access barriers.
Participate in care planning with the patient and healthcare team to identify interventions for rehabilitation, treatment goals, and quality of life improvement.
Assess patient knowledge of kidney disease and barriers to treatment adherence.
Assess social determinants of health impacting treatment and assist in identifying community resources.
Assist patients and/or families/caregivers in completing applications for services and resources.
Provide ongoing education on psychosocial issues related to CKD and ESRD and available support services.
Enable support groups and family members in dealing with and understanding patient needs.
Develop detailed and error-free case notes involving mental health and risk assessments.
Adjust treatment plans in compliance with patient status changes.
Provide information and assist the team and patient with referrals to community resources.
Provide supportive and goal-directed counseling to patients seeking transplant.
Assess patient awareness of advance directives and facilitate discussions.
Participate in discussions regarding patient DNR status to ensure understanding and informed decision-making.
Utilize motivational interviewing techniques for non-adherence and quality of life concerns.
Collaborate with Facility Management and Accounting/Billing to address patient insurance or copay concerns.
Conduct in-center and face-to-face visits to assess patient needs and implement a plan of care (up to 50% same-day travel).
Educate patients on insurance options (GHPs, Medicare, Medicaid, managed care plans) and serve as a liaison.
Assist patients in understanding financial responsibilities, payment arrangements, and financial assistance programs.
Maintain accurate records of patient insurance information, care plans, and assessments.
Perform other duties as assigned.

Requirements

Master’s degree in social work.
Active and unrestricted state-specific licensure required; Licensed Clinical Social Worker.
Dialysis experience in a renal setting working with ESRD & CKD patients.
Excellent communication skills; ability to communicate clearly and concisely both orally and in writing to patients, family members and various professionals.
Basic computer skills and understanding.
Five (5) years of related work experience.
Two (2) years of experience working with the dialysis/kidney care population.
Fluency in both English and Spanish.
Track record of excellent customer service skills.
Medicare or Medicaid experience preferred.
Proof of COVID-19 vaccination, annual Influenza vaccination, along with immunizations for Hepatitis, MMR, Varicella, Tdap, and TB for employment.

Skills

Works and communicates well in a team environment.
Displays ethical conduct at all times toward patients, families, and co-workers.
Completes training as required and demonstrates professional effectiveness and positive demeanor.
Maintains a customer/client focus.
Strong understanding of insurance, Medicare, Medicaid, patient payment processes.
Strong interpersonal skills to effectively manage patient needs.
Motivational interview techniques.

Location

Northern VA

Work Type

On-site
Travel between outpatient facilities is required

Experience Level

Five (5) years of related work experience
Two (2) years of experience working with the dialysis/kidney care population

Education Level

Master’s degree in social work
Licensed Clinical Social Worker

Salary/Compensations

$78,000 to $85,000 per year

About the Company

As a leading provider of outcomes-driven care for individuals and communities living with chronic conditions, Somatus is helping patients across the country enjoy More Healthy Days at Home™.
Care at Somatus goes beyond treatment. Through a whole‑person approach, we deliver outcomes‑driven integrated care and show up #SomatusStrong for our patients and teammates.
We partner closely with health plans, health systems, and provider groups to support patients with, or at risk of developing, cardio, kidney, metabolic, or other chronic conditions.
We hire the brightest and boldest — talent driven by purpose and impact.
Since our founding in 2016, our growth trajectory isn’t just a milestone — it’s a signal.
Our leadership values culture and leads with intention as we remain dedicated to driving clinical excellence.

Equal Opportunity

Somatus, Inc. provides equal employment opportunity to all individuals regardless of race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by law. Discrimination of any type will not be tolerated.