Hospital Social Worker MSW – Care Coordination & Discharge

Health First; Palm Bay (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

Health First is seeking a Social Worker MSW to coordinate patient care using advanced psychosocial skills. You will assess, plan, intervene, and evaluate care while leveraging hospital and community resources to achieve optimal outcomes, collaborating with patients, families, physicians, and payers.

Your role includes discharge planning, post-discharge referrals, and supporting patients with complex needs. Strong knowledge of payer practices and regulatory standards is required.

Qualifications

• MSW degree or equivalent social work qualifications as required.
• Certified case management is preferred for advanced roles.
• Experience with discharge planning and care coordination.

Responsibilities

• Coordinate referrals for post-acute services in a timely manner.
• Communicate with patient caregivers and physicians on financial issues.
• Coordinate and document complex discharge plans.
• Explain discharge goals and options to patient/family and care team.
• Participate in patient care conferences and ethics consultations as needed.
• Provide counseling and research placement options for substance use, mental health, homeless, and indigent patients.
• Facilitate transfer to mental health facilities and provide therapeutic interventions.
• Complete mandatory reporting processes.
• Facilitate referrals for post-discharge psychosocial and other needs.
• Identify system/process improvements and escalate delays to remove barriers.

Skills

MS Office – Outlook and Word

Healthcare economics knowledge

Social work scope of practice

Payer/reimbursement regulations

Regulatory compliance awareness

Multitasking in short timeframes

Education

Master’s of Social Work

Bachelor’s in Social Work with Master’s in related field

CCM or ACM Case Management Certification

Job description

Health First is seeking a Social Worker MSW to coordinate patient care using advanced psychosocial skills. You will assess, plan, intervene, and evaluate care while leveraging hospital and community resources to achieve optimal outcomes, collaborating with patients, families, physicians, and payers.

Your role includes discharge planning, post-discharge referrals, and supporting patients with complex needs. Strong knowledge of payer practices and regulatory standards is required.