Discharge & Care Coordination Social Worker

McLaren Health Care Corporation; Petoskey (MI); On-site; USD 33,000 - 47,000; Part time

Job summary

McLaren Health Care is seeking a part-time Social Worker to assess and intervene with patients and families, improving health and wellness through discharge planning and community resource linkage.

You will collaborate with an interdisciplinary team, manage complex discharge plans, and document care in the EMR while navigating insurance coverage and post-acute services to support transitions.

Qualifications

• Licensed Master’s Social Worker (LMSW) with certification within one year of eligibility
• American Case Management Certification (ACM) or CCM eligibility and ongoing CE requirements

Responsibilities

• Performs high level triage of all patients within 24 hours of admission
• Receives RN Care Manager referrals based on Social Work triggers
• Identifies and assesses barriers early in the patient’s stay and formulates a plan with the team
• Assesses patient/family needs for support and connects to community resources
• Assesses risk of readmission and initiates interventions for smoother transitions
• Participates in family care conferences and interdisciplinary rounds
• Documents in the EMR and ensures transfer of information to post-acute agencies
• collaborates with care teams to ensure timely transitions to next level of care
• Utilizes insurance benefits knowledge to maximize resource use

Skills

Crisis management

Multitasking

Communication

Computer literacy

Problem solving

Teamwork

Interpersonal skills

Education

MSW degree

ACM certification

CCM certification

Tools

Cerner

Paragon

Meditech

InterQual

Optum

Job description

McLaren Health Care is seeking a part-time Social Worker to assess and intervene with patients and families, improving health and wellness through discharge planning and community resource linkage.

You will collaborate with an interdisciplinary team, manage complex discharge plans, and document care in the EMR while navigating insurance coverage and post-acute services to support transitions.