Social Worker Care Advocate, Full Time Days

Relocation Assistance Available!! Facility Cape Fear Valley Medical Center Location Fayetteville, North Carolina Department Women & Children Administration Job Family Professional Work Shift Days (United States of America) Summary The Care Advocate serves as the trusted point of contact for pregnant and postpartum patients from enrollment through 12 months postpartum. The role combines empathetic engagement, structured brief assessment/intervention, care planning with shared decision-making, motivational interviewing techniques, closed-loop referrals, and consistent communication with OB, pediatrics, primary care, behavioral health, and community partners. The Care Advocate documents all contacts, follows site safety protocols, and contributes to quality improvement and evaluation. MAJOR JOB FUNCTIONS The following is a summary of the major essential functions of the job. The incumbent may perform other duties, both major and minor, that are not mentioned below; and specific functions may change from time to time. Review automated screening results and relevant EHR information daily. Conduct phone or video assessments for positive screens (mental health, substance use, IPV, SDoH, high-risk conditions). Deliver brief interventions (SBIRT principles), education, and collaborative care plans using motivational interviewing and shared decision-making. Triage and manage risks; escalate medical concerns to nursing/APRN partners and behavioral health emergencies per SOPs (suicide, overdose, psychiatric crisis, IPV danger). Complete warm handoffs; schedule with internal/external providers; ensure information exchange consistent with privacy laws and consents. Confirm engagement with referrals; troubleshoot barriers (transport, childcare, cost, coverage, language, etc.); re-engage as needed. Document assessments, plans, and follow-ups in the program platform and per site EHR standards (progress notes, messages). Communicate promptly with clinical teams about risks, plans, and updates; use closed-loop processes. Maintain accurate, timely logs and dashboards for fidelity and performance monitoring. Contribute to building and updating the site resource library; tailor resource lists to geography and patient preferences. Collaborate with the Patient Engagement Lead and community partners to strengthen pathways and reduce handoff failures. Other duties as assigned MINIMUM QUALIFICATIONS The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job: EDUCATION AND FORMAL TRAINING: Masters degree in social work required Licensed Clinical Social Worker in North Carolina required WORK EXPERIENCE: 2 years in care coordination/case management or patient navigation required 2 years of experience in behavioral health management required 1 year of experience conducting mental health/SUD risk assessments, brief interventions and referrals required 1 year of experience in obstetrics or maternal health preferred KNOWLEDGE, SKILLS, AND ABILITIES: Proficiency in reading, writing and speaking the English language Bilingual (English/Spanish) preferred Knowledge of community resources and patient advocacy; experience with diverse populations and equity-focused, trauma-informed care. Proficiency with technology-enabled communication (texting platforms, telehealth) and accurate documentation Excellent interpersonal communication and negotiation skills Ability to communicate effectively and work with people of all social, economic and cultural backgrounds Proven written, telephonic and electronic communication skills Assertive and persuasive interactions with customers, peers, management and core staff served Strong organizational and time management skills Flexible, open-minded and adaptable to change PHYSICAL REQUIREMENTS: Light carrying and lifting may be required Walking may be required to access all areas of the Medical Center Ability to effectively communicate orally to patients, family members, personnel and physicians Visual acuity to proofread hand or typewritten materials Required Licenses and Certifications Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity