Central Health

Medical Social Worker (MSW) – Cancer Prevention Program

Req No.
CommUnityCare Health Centers
Southeast Health and Wellness Center
2901 Montopolis Drive
Medical Services
Regular Full-Time


In collaboration with patients, families (as defined by patient) and staff across all disciplines and departments, the Medical Social Worker will serve as the Patient Navigator for a cancer prevention program, funded by the Cancer Prevention Research Institute of Texas (CPRIT), to increase colorectal cancer-screening rates among the CommUnityCare patient population. This person is responsible for supporting the goals of the program and applying empowerment-based prevention and intervention strategies to improve community health specifically related to colorectal screening, making referrals to community-based resources, addressing barriers to improving well-being, offering expertise regarding psycho-social issues affecting patient care, and educating patients regarding illness and treatment options.


This is a three (3) year grant funded position and will be a co-hire with the University of Texas at Austin Dell Medical School.


  • Apply empowerment-based prevention and intervention strategies to improve community health and facilitate colorectal cancer screening, follow-up and treatment.
  • Follow-up with patients who have a positive screening test, navigate these patients through the complex health care system and ensure completion of colonoscopy and other appropriate diagnostic procedures.
  • Field questions about colorectal cancer, screening, test completion and follow-up care.
  • Collaborate with the Clinical Technician to meet CPRIT grant objectives and meet regularly with the Program Coordinator from the University of Texas at Austin Dell Medical School.
  • Assist with data management related to colorectal cancer screening, including tracking of completed tests and management of testing databases.
  • Identify and provide referrals for patients to appropriate, accessible community-based resources and treatments related to colorectal cancer screening and treatment.
  • Provide accurate and complete documentation of all patient contacts, patient progress towards colonoscopy completion, and results of screening tests and colonoscopy procedures.
  • Address personal and environmental issues with the patient in order to maximize emotional, social, and physical wellbeing and the appropriate use of healthcare resources.
  • Offer the “person-in-environment” perspective, which incorporates all factors that influence a patient’s health care experience.
  • Help patients and families understand colorectal cancer screening, screening and test results, follow-up procedures and treatment options, as well as consequences of various treatments or treatment refusal.
  • Provide the expertise, consultation, and education in areas relating to psycho-social issues affecting patient care.
  • Communicate and collaborate with clinic providers and support staff to assess patient’s needs and provide comprehensive healthcare.
  • Seek opportunities and implement goals for own professional development.
  • Perform other duties as assigned related to the CPRIT Research Grant in collaboration with the University of Texas at Austin Dell Medical School.
  • Complete all direct and indirect care documentation in timely manner and ensure patient records are current and complete.
  • Attend patient care (unit) huddles and periodic informational (clinic) huddles, meetings, patient conferences, or planning sessions. These may be related to quality assurance, patient care and other related topics within the clinic.
  • Collaborate and communicate with the University of Texas Dell Medical School Department of Medicine Program Coordinator.
  • Attend seminars and maintain all licensure and/or certification requirements for continuing education and best practices.
  • Participate in quality strategies to evaluate compliance with evidence-based guidelines, standards and to identify opportunities to improve patient outcomes.
  • Ensure all tasks provided and associated with patient care, patient administrative processes and related duties comply with all regulatory and accreditation standards including The Joint Commission and CommUnityCare Standard Operating Procedures and CommUnityCare Policies and Procedures.
  • Develop and maintain favorable internal relationships, partnerships with co-workers, including clinical managers, clinical support staff, providers and business office staff.
  • Interact respectfully and collaboratively with patients and their families, striving to develop favorable relationships with families.
  • Collaborate with all members of the care team in providing patient-centered care.
  • Commitment to and skills in working with diverse populations.


  • High level of skill at building relationships and providing excellent customer service.
  • High degree of knowledge and competency in mental health treatment plans, and motivational interviewing skills.
  • High level of problem solving skill to better serve patients and staff.
  • Strong attention to detail and accuracy.
  • Excellent verbal and written communication skills.
  • Demonstrated knowledge of community resources available and how to access resources for the benefit of clients.
  • Demonstrated experience conducting social work services in both individual and group settings.
  • Demonstrated success in collaborating with other healthcare providers for patient-centered care.


MINIMUM EDUCATION: Master’s Degree in Social Work (MSW)


PREFERRED EXPERIENCE: Medical social work experience.



  • Current license as LMSW required in the State of Texas.
  • Basic Life Support (BLS) obtained through approved American Heart Association. Will be required to maintain a current BLS certification during employment.
  • Bilingual (English / Spanish).


Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed