Discharge planner/Case Manager, MSW or BSW

Mary Washington Healthcare; Fredericksburg (VA); On-site; USD 43,000 - 70,000; Full time

Job summary

Mary Washington Healthcare is seeking a Case Manager, Discharge (BSW/MSW) to organize and expedite discharge plans for medically complex patients. The role involves coordinating with clinical partners, educating patients and families about resources, and supervising discharge planning and documentation.

Experience in healthcare and a social work credential are preferred. The position supports end-of-life planning, guardianship issues, and collaboration with post-acute facilities to ensure safe

Qualifications

• Bachelor’s degree in Social Work is required.
• Master’s degree in Social Work is required.
• Experience with Windows-based programs, e-mail, and Microsoft Word is required.
• Case Management Certification strongly desired.

Responsibilities

• Coordinate care with clinical partners and advance patient outcomes.
• Assess long-term care needs and changes in independence or function.
• Provide discharge planning and education to patient and family.
• Communicate treatment plan updates to the care team and document in medical records.
• Facilitate comprehensive care planning and interdisciplinary collaboration.
• Address delays or barriers to discharge and engage with contracted post-acute partners.

Skills

Strong communication

Critical thinking

Education

Bachelor’s degree in Social Work

Master’s degree in Social Work

Tools

Windows based programs

Email

Microsoft Word

Job description

Start the day excited to make a difference…end the day knowing you did. Come join our team.

Job Summary:

The Case Manager, Discharge (BSW) will organize and expedite a treatment plan of care for medically complex and difficult social issues related to hospital progression of care. The incumbent will identify discharge needs and develop a discharge plan, promote communication and collaborative coordination amongst care providers, and provide information and education on community resources. Additionally, the position will coordinate care of patients with clinical partners, provide intervention in cases of child/elder abuse/neglect and guardianship issues, and serve as a resource for treatment decisions surrounding end of life and Medical Power of Attorney.

Essential Functions and Responsibilities:

• Coordinates care of patients with clinical partners; helps patients advance towards realistic and desirable outcomes.
• Assesses long term and/or future patient care needs by identifying probable changes in level of independence or functional quality.
• Communicates activity status updates regarding treatment plan with clinical partners.
• Provides information and education on community resources to patient and their families.
• Develops, coordinates, and communicates discharge plans with the patient, family members and care team for medically complex and difficult social issues related to hospital progression. Documents assessment and overall discharge plan in medical record.
• Collaborates with leadership to appropriately address concerns related to delays in discharge, barriers to discharge and trends noted.
• Provides intervention in cases of child/elder abuse/neglect and guardianship cases.
• Serves as a resource person related to treatment decisions surrounding end of life and Medical Power of Attorney.
• Facilitates meetings and comprehensive care planning with interdisciplinary team. Delegates work to support team members.
• Utilizes post-acute care facilities for safe and effective discharge planning.
• Collaborates with contracted partners associated with financial needs to facilitate post-acute facility placement.
• Conducts psychosocial assessment as needed for development of appropriate discharge plan for medically complex and difficult social issues.
• Performs other duties as assigned.

Qualifications for BSW- $30.90-$43.26

• Bachelor’s degree in Social Work required.
• A minimum of one year experience in social work required.
• Experience with computer technology, specifically experience with Windows based programs, e‑mail, and Microsoft Word required.
• Experience in a healthcare field preferred.
• Case Management Certification strongly desired.

Qualifications for MSW- $34.07-$51.10

• Master's degree in Social Work required.
• A minimum of one year experience in social work required.
• Experience with computer technology, specifically experience with Windows based programs, e‑mail, and Microsoft Word required.
• Experience in a healthcare field preferred.
• Case Management Certification strongly desired.

MWHC will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status (EOE). We are also committed to equitable and transparent compensation practices and comply with all applicable pay transparency and pay equity laws.

Required

Physical Requirements

Constant (67-100% of workday) use of arms and hands; frequent (34-66% of workday) standing, walking, and sitting; occasional (0-33% of workday) bending, stooping, and squatting; ability to lift 35 lbs.; ability to push and pull up to 20 lbs.; auditory and visual skills to include color determination.

Mental Requirements

Possesses critical thinking and analytical skills. Ability to multi-task. Ability to communicate effectively and collaborate with a multi-disciplinary team. Capacity to cope with difficult situations. Ability to tolerate irregular hours including evenings, nights, and weekends.

Environmental Requirements and Exposure Hazards

Potential risk of exposure to radiation and toxic chemicals. Potential for exposure to bloodborne pathogens; must be able to wear appropriate personal protective equipment.

“It is the policy of Mary Washington Healthcare to provide reasonable accommodations to qualified individuals with a disability who are applicants for employment or Associates.”

Compensation Pay Range

$30.90 - $51.10