Discharge Planning Social Worker - Care Transitions

GBMC HealthCare; Towson (MD); On-site; USD 58,000 - 94,000; Full time

Job summary

GBMC HealthCare in Towson, MD seeks a Social Worker in Continuing Care to assess and coordinate post-discharge plans within a multidisciplinary hospital team, interfacing with patients, families, and care providers.

The role emphasizes discharge planning, education on resources and advance directives, and navigating health care systems to ensure continued care and compliant treatment.

Qualifications

• Masters in Social Work required; equivalent experience considered.
• Licensed in Maryland as LMSW or LCSW.
• 1-3 years prior hospital discharge planning experience preferred.

Responsibilities

• Interview patients and families to assess psychosocial needs.
• Facilitate family meetings to identify needs and develop continuing care plans.
• Educate patients and families about community resources, end-of-life care, and health insurance.
• Coordinate complex care plans with home health, social services, rehab, and mental health providers.

Skills

Interview skills

Assessment skills

Cultural competency

Active listening

Empathy

Motivational interviewing

EMR familiarity

Education

Masters in Social Work

Tools

EMR

Job description

GBMC HealthCare in Towson, MD seeks a Social Worker in Continuing Care to assess and coordinate post-discharge plans within a multidisciplinary hospital team, interfacing with patients, families, and care providers.

The role emphasizes discharge planning, education on resources and advance directives, and navigating health care systems to ensure continued care and compliant treatment.