Registered Nurse

Job description

Job Duties:
The Clinical Care Team will take referrals from primary care providers and will work with the primary care team to accomplish the following tasks:
Social support navigation for social determinants of health (SDOH) such as food insecurity, housing insecurity, etc.
o Compile and maintain a resource list for SDOH resources including eligibility criteria, referral process, and contact information
o Collaborate with primary care nurse and providers.
o Provide in-person or remote social needs screening/assessment with primary care patients referred by nurse or provider
o Coordinate or make aware of social services resources, i.e., housing, clothing, food, mental health services, etc.
o Collaborate with other social workers to identify patient and community resources

• Ongoing for 12 months