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Upperline Health Social Worker in Nashville, Tennessee


About Us

Upperline Health is an innovative and fast-growing healthcare company focused on bringing more specialties into value-based care. We are a physician practice caring for patients with chronic illnesses with an emphasis on diabetes and vascular disease who we treat through co-management with our specialists such as podiatrists, endocrinologists, wound care providers and vascular care providers and in collaboration with their PCP.

Our team provides an additional layer of clinical and psychosocial support for patients with chronic illnesses. Upperline's interdisciplinary team sees patients in the clinic, home, hospital and facilities and provides wrap-around services including 24/7 clinical support, remote patient monitoring, behavioral health telemedicine and other resources. We help provide relief from the burdensome symptoms of chronic illness, help patients and caregivers navigate the healthcare system, and guide patients through difficult treatment choices. Upperline Health is based out of Nashville, TN and has clinics in Alabama, California, Florida, Georgia, Indiana, Kentucky and Tennessee.


Why join our team?

  • Highly competitive salary 

  • Generous benefits: comprehensive benefit options include medical, dental and vision, 401K and PTO.

  • Supportive team


About the Social Worker Role

Upperline Health is seeking a social worker who will be responsible for providing supportive and medical social services to patients and their families in the home. This will include a range of tasks such as directly providing support to Upperline’s patients and families in the home as well as coordinating patient transition from facility to the home. The Upperline Social Worker assists the medical team in completing comprehensive psycho-social assessment to identify issues related to social determinates of health and collaborate in care plan development with as a vital part of the interdisciplinary team to address individual patient’s unique psychosocial needs, health status, and overall goals and values. 

Ideal candidates will have experience working with Medicare patients. Most importantly, candidates must demonstrate compassion for patient needs, have great attention to detail and thrive in a collaborative environment.


This position is hybrid in-office and remote.


What You’ll Do

  • Assess and provide intervention to address patient and family physical and psychosocial needs in collaboration with the interdisciplinary team

  • Communicate with other Upperline clinical team members, patient’s other physicians and patient’s other medical providers to coordinate optimal care and resources for the patient and his or her family including:

  • Social support and transportation needs

  • Financial counseling

  • Identifying non-clinical community resources

  • Mitigating family dynamics and patient compliance issues

  • Assisting patient in logistically accessing healthcare services available to them

  • Assess, identify and close clinical and non-clinical gaps in patient care

  • Appropriately triage and escalation of routine, urgent and emergent patient calls

  • Document social work assessments, care plans, and interventions

  • Provide brief, targeted counseling and intervention for psychosocial, emotional issues related to social determinants of health.

  • Collaborate with field-based NPs and physicians to develop and implement effective treatment plans and interventions for complex patient care issue

  • Identify community resources and assisting Upperline’s patients and families in accessing those resources

  • Complete various clinical and administrative tasks

  • Participate in weekly interdisciplinary team meetings

  • Complete other related duties as deemed necessary by Upperline Health


Qualifications of the Social Worker

  • Candidates should be excited and energized by the prospect of working collaboratively as part of an innovative team

  • Master’s degree in social work from an accredited institution is required

  • Appropriate licensure at the state level to practice social work in the state where you reside and ability to obtain licensure in other states as deemed necessary

  • Minimum of 3 years social work experience required, preferably in a centralized care management team environment

  • Prior healthcare experience serving chronically ill patients living with limited resources, serious emotional disturbance, and/or mental illness preferred

  • Telephonic case management or care coordination experience preferred

  • Strong customer-service orientation

  • Patient, compassionate and professional demeanor required

  • Exceptional organizational skills and ability to multi-task

  • Self-starter with an entrepreneurial spirit and demonstrated problem solving skills

  • Strong writing, Word, Excel, and database management skills

  • Extremely strong work ethic

  • Experience working in a fast-growing, rapidly changing environment

  • Must have reliable automobile, valid driver’ s license and minimum state required liability auto insurance; Social Workers travel in personal vehicle with reimbursement for mileage



Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience


Job Type: Full-time

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