Discharge & Care Coordination Social Worker

Aurora Health Care; Sheboygan (WI); On-site; USD 55,000 - 75,000; Full time

Job summary

Aurora Health Care in Wisconsin is seeking a licensed social worker to provide psychosocial assessments, discharge planning, and community resource coordination for patients and families. The role focuses on safe transitions and patient-centered care within a hospital setting.

Responsibilities include collaboration with the care team, CMS and regulatory compliance, and ongoing support to patients through the hospital stay.

Qualifications

• Demonstrated knowledge of social work principles and methods in healthcare.
• Ability to collaborate with multidisciplinary teams to coordinate care.
• Strong documentation and care coordination to support discharge planning.

Responsibilities

• Coordinate post-acute placement and community resources.
• Educate patients and families on advance directives and care planning.
• Maintain compliance with NASW code of ethics and regulatory requirements.
• Assist with discharge planning and avoidance of unnecessary delays.
• Engage with payers and external reviews as needed to support UM activities.

Skills

Social work principles

Team collaboration

Care coordination

Regulatory compliance

Education

MSW

LCSW preferred

WI Social Work Certification

Job description

Aurora Health Care in Wisconsin is seeking a licensed social worker to provide psychosocial assessments, discharge planning, and community resource coordination for patients and families. The role focuses on safe transitions and patient-centered care within a hospital setting.

Responsibilities include collaboration with the care team, CMS and regulatory compliance, and ongoing support to patients through the hospital stay.