Discharge Care Navigator (MSW)

Mary Washington Healthcare Incorporated; Fredericksburg (TX); On-site; USD 47,000 - 70,000; Full time

Job summary

MaryWashingtonHealthcare is seeking a Case Manager, Discharge (MSW) to organize and expedite discharge plans for medically complex cases. You will coordinate with clinical partners, provide resources, and guide care teams through challenging social issues, including guardianship and end-of-life decisions.

The role requires an MSW, healthcare experience preferred, and strong communication skills. You will mentor junior staff and help ensure smooth hospital progression and discharge outcomes.

Qualifications

• Master's degree in Social Work required.
• A minimum of one year experience in social work required or two-semester internship completed within MWHC Care Coordination department.
• Experience with Windows-based programs, e-mail, and Microsoft Word is required.
• Experience in a healthcare field is preferred.
• Case Management Certification strongly desired.

Responsibilities

• Coordinates care of patients with clinical partners; helps patients advance towards realistic and desirable outcomes.
• Serves as a subject matter expert and resource for care team members.
• Mentors new social work Associates in Care Coordination and social work student interns.
• Assesses long-term and future patient care needs by identifying changes in independence or functional quality.
• Communicates activity status updates regarding treatment plans with clinical partners.
• Provides information and education on community resources to patients and families.
• Develops, coordinates, and communicates discharge plans with patient, family, and care team; documents in medical record.
• Assists with audits and assessments of discharge planning documentation and complex care coordination situations.

Skills

Critical thinking

Communication

Multi-tasking

Collaboration

Education

Master's degree in Social Work

Two-semester internship completed within MWHC Care Coordination department

Tools

Windows

Microsoft Word

Email

Job description

MaryWashingtonHealthcare is seeking a Case Manager, Discharge (MSW) to organize and expedite discharge plans for medically complex cases. You will coordinate with clinical partners, provide resources, and guide care teams through challenging social issues, including guardianship and end-of-life decisions.

The role requires an MSW, healthcare experience preferred, and strong communication skills. You will mentor junior staff and help ensure smooth hospital progression and discharge outcomes.