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Social Worker (SDOH)

22nd Century Technologies, Inc.
$27.23 / hr
United States, Tennessee, Columbia
Jun 02, 2025
Job Title: Social Worker (SDOH)

Pay Rate: $27.23 Per /hr With state holidays and PTO dats as well as health insurance benefits

Location: 1216 Trotwood Avenue Columbia 38401 TN

Duration: 03+ months

Job Description:


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.

    • Compile and maintain a resource list for SDOH resources including eligibility criteria, referral process, and contact information
    • Collaborate with primary care nurse and providers
    • Provide in-person or remote social needs screening/assessment with primary care patients referred by nurse or provider
    • Coordinate or make aware of social services resources, i.e., housing, clothing, food, mental health services, etc.
    • Collaborate with other social workers to identify patient and community resources


  • Conduct case management activities

    • Work with hospitals for discharge planning, follow-up and education
    • Assist with obtaining patient records from hospitals
    • Assist in securing needed medical equipment through community partners
    • Conduct follow-up on care plans
    • Identify patients lost to follow-up or overdue for care and assist them in returning to care


  • May assist with specialty referral navigation

    • Schedule, coordinate, and track non-BCS specialist and imaging referrals
    • Assist with obtaining patient records from specialists and imaging centers
    • Compile and maintain resource list for specialty referrals including eligibility criteria, referral process, cost and contact information


  • Assist patients to locate and access low-cost prescription options such as patient assistance programs, discount retailers, etc.

    • May assist with patient assistance program applications and serve as a patient-provider liaison with the drug companies
    • Assist patient with applications for programs such as CoverRx and RxOutreach


  • May help with other regional primary care-based initiatives with a social work component
  • Documents in patient's record, updates consults, and tags provider and/or clinical staff as necessary
  • Provide patient education or find appropriate education resources.


Tools and Equipment:

  • Personal Computer
  • Telephone
  • Fax Machine
  • Printer
  • Scanner
  • Copy Machine
  • Calculator
  • Personal Vehicle

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