Discharge & Care Coordination Social Worker

4010 Wellstar Spalding Regional Hospital, Inc.; United States; On-site; USD 65,000 - 80,000; Full time

Job summary

Wellstar Health System is seeking a Care Coordination Social Worker to assess transitional care needs, coordinate across the care continuum, and engage patients and families to ensure safe discharge planning. You will serve as a resource to patients, advise the care team on psychosocial and discharge issues, and help connect patients to community services and post-acute placements.

Responsibilities include psychosocial assessments, collaboration with nurses and physicians, and guiding families

Qualifications

• Excellent written and verbal communication skills are required.
• Experience collaborating with physicians and care teams to support discharge planning.
• Knowledge of local, state and federal resources for patient care transitions.

Responsibilities

• Implements discharge planning and provides resource information for patients.
• Identifies barriers to timely disposition and documents them.
• Participates in interdisciplinary rounds to confirm discharge date and plan.
• Initiates post-acute referrals for timely care transitions.
• Documents progress notes and services in the medical record.

Skills

Communication

Maturity

Autonomy

Stress management

Assessment skills

Regulations knowledge

Community resources

Team collaboration

Education

BSW/MSW

Tools

Electronic Health Records

Job description

Wellstar Health System is seeking a Care Coordination Social Worker to assess transitional care needs, coordinate across the care continuum, and engage patients and families to ensure safe discharge planning. You will serve as a resource to patients, advise the care team on psychosocial and discharge issues, and help connect patients to community services and post-acute placements.

Responsibilities include psychosocial assessments, collaboration with nurses and physicians, and guiding families