Pediatric One Care Behavioral Health Clinician
The Pediatric One Care Behavioral Health Clinician supports children with complex medical, behavioral, and developmental needs—such as asthma, obesity, and developmental or behavioral health challenges—by working closely with families, pediatricians, and the broader TMIN Pediatric One Care Team. This role focuses on addressing social, emotional, and behavioral health needs that impact a child’s well-being and care outcomes.

Through collaboration with primary care providers, schools, specialists, and community agencies, the Behavioral Health Clinician helps develop and implement individualized care plans that promote stability, support development, and improve quality of life. The Behavioral Health Clinician provides psychosocial assessments, care coordination, education, and short-term interventions to help families navigate systems of care, access resources, and build sustainable supports.

By centering family strengths and addressing social determinants of health, the Behavioral Health Clinician plays a critical role in empowering families, enhancing engagement in care, and supporting children to thrive in their homes and communities.

About TMIN

Our Integrated Network brings together a diversity of experienced private practice and employed physicians as well as community and academic providers. While we are one unified network, we focus on different geographic regions, with local care teams convening to ensure healthy, happy neighborhoods throughout the greater Boston region.

Location - Hybrid with occasional onsite trave in MA

Job Overview

This position provides a range of clinical social work services to patients/clients and families in inpatient, ambulatory and community settings utilizing individual, family or group modalities and practicing within the guidelines of professional social work ethics and standards. Participates in a multi-discipline case conferences. Consult with agency care providers regarding social service needs of clients and families.

Job Description

Minimum Qualifications:

1. Master’s degree in Social Work from an accredited institution.

2. Licensed Clinical Social Worker (LCSW). Licensure in NH may be required depending on assigned territory and operational need.

3. One (1) year of related experience.

Preferred Qualifications:

1. Three (3) years of related experience.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Provides psychosocial assessment of the individual and family, including limitations, deficits and strengths in their current situation and environment, as well as functional level. May conduct a psychiatric social work assessment according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Develops treatment plans with appropriate and competent interventions.

2. Responsible for psychosocial assessments and interventions in crisis situations that often involve issues of suicide, homicide, family violence, elder or child abuse.

3. Demonstrates sound clinical judgment in assessing the patient's needs for long-term care, including evaluating the home and family situation, helping the patient and family to develop an in-home care plan, exploring alternatives to in-home care and arranging for placement if necessary.

4. Provides treatment, therapy, psycho-education and/or counseling utilizing individual, family or group modalities.

5. Provides information, referral and creative resource acquisition for specific individual and family needs both within the Hospital and in the community as indicated. Assists patients/families to understand psychosocial factors impeding their maximal utilization of hospital and community resources.

6. Collaborates with and provides psychosocial consultation to the health care team to promote a smooth, coordinated plan of care. Aids the team in understanding and integrating the significance of psychosocial factors in relation to patient's illness, treatment and recovery. Identifies psychosocial issues that may impede progress. Makes recommendations to the team regarding patient/family care and management. Assists health care team to assist patient/family level of understanding to make informed decisions.

7. Provides medical social services to the patient’s family member or caregiver on a short-term basis when necessary to remove a clear and direct impediment to the effective treatment of the patient’s medical condition or rate of recovery.

8. Treats patients and families with dignity and respect at all times. Offers time for questions and answers; demonstrates empathy in communication while working toward optimal health goals.

9. Provides outreach, case finding/screening for high-risk issues that may impact on patient's progress, participation in plan, discharge or ability to utilize resources.

10. Assists with discharge planning issues to ensure continuity of care. Formulates, coordinates and implements the psychosocial components of outpatient care.

11. Consults, collaborates and communicates with a wide range of social, governmental and legal agencies, courts, schools, clinics, other hospitals, physicians and other sources.

12. Serves as a patient/family advocate with a variety of systems both internally and externally as required. May be called upon to testify in court.

13. Ensures clinical documentation is complete and according to departmental standards. Performs other administrative documentation and record keeping, such as accountability and statistical reports, billing forms, student intern evaluations, performance evaluations, etc. in complete and timely manner.

14. Initiates policy and program development in specific service area or team, utilizing knowledge of state-of-the-art programs and promoting social work values such as patient self-determination and social justice. Initiates, participates in and supports policy and program development in the Department of Social Work Services.

15. Actively engages in the regularly scheduled meetings, programs and activities of the Department. Serves on departmental committees. Represents the profession and Department in hospital and community meetings and committees.

16. Participates in social work professional education, supervision and teaching activities; supervises or trains staff social workers, student interns, house staff, nurses, medical students, and volunteers as required.

17. Maintains collaborative, team relationships with peers and colleagues in order to effectively contribute to the working groups achievement of goals, and to help foster a positive work environment

18. Continually monitors, assesses and modifies his/her own social work practice and programs. Conducts quality improvement activities and research regarding service delivery and effectiveness of interventions, as required.

19. Conducts or participates in professional organizations, grant writing, teaching, public presentations, seminars and workshops. May supervise staff social workers, social work associates, social work interns, parent consultants, house staff, nurses, medical students and volunteers as required. Responsible for making recommendations to the Director of Social Work Services regarding service delivery gaps, systemic issues and program development.

20. Ensures compliance within guidelines set forth by regulatory agencies (DPH, ERISA etc.) and demonstrates compliance with Home Health Foundation policies and procedures. Practices confidentiality principles set by the agency and federal HIPAA/HITECH guidelines.

Physical Requirements:

1. Normal office setting.

Skills & Abilities:

1. Possesses and applies the skills and knowledge necessary to provide care to patients throughout the life span, with consideration of aging processes, human development stages and cultural patterns in each step of the care process.

2. Knowledge of casework process and community resources in relation to health (including mental health), illness, and disability.

3. Knowledge of current social work theory and practice, the ability to apply treatment and case management methods, and familiarity with community issues and resources.

4. Understanding of organizational theory and practice in large systems and the knowledge of social and health care policies and systems.

5. High degree of diagnostic, treatment, interpersonal, organizational, and communication skills.

6. Analytical skills required assessing patient needs, to develop associated treatment modalities and to provide effective counseling.

7. Computer skills and knowledge of general office programs, spreadsheet programs, database programs, and presentation programs (Word, Excel, Access, PowerPoint).

8. Ability to read/write and communicate in English.

9. Excellent interpersonal skills.

10. Ability to function well in very busy situations.

11. Responsible and reliable.

12. Good organization skills.

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