MSW Continuing Care Liaison — Home Health & Transitions

Dartmouth-Hitchcock Health; Hartford (VT); On-site; USD 60,000 - 80,000; Full time

Job summary

Dartmouth-Hitchcock Health is seeking a Continuing Care Liaison – MSW in Vermont to join our Home Care team. You will be integral to coordinating patient transitions from acute care to home, collaborating with discharge planners and a multi-disciplinary team to ensure seamless care.

The role requires an MSW with at least one year in health-related work, LICSW preferred, and a passion for community-based care. A driver’s license and ability to travel within Upper Valley area are expected.

Qualifications

• Must have Master of Social Work (MSW).
• Minimum one year experience in a health-related field.
• Collaborative team player with strong problem-solving skills and adaptability.

Responsibilities

• Integrate into a multi-disciplinary team to ensure continuity of care.
• Document observations, interventions and evaluations for patient care.
• Coordinate with discharge planners and providers to transition patients home.
• Provide information and education to patients/families about home-based care and develop a care plan.
• Advocate for patient needs and navigate complex systems to remove barriers.

Skills

Team collaboration

Discharge planning

Care coordination

Documentation

Home health care

Education

Master of Social Work (MSW)

LICSW preferred

Tools

EMR systems

Job description

Dartmouth-Hitchcock Health is seeking a Continuing Care Liaison – MSW in Vermont to join our Home Care team. You will be integral to coordinating patient transitions from acute care to home, collaborating with discharge planners and a multi-disciplinary team to ensure seamless care.

The role requires an MSW with at least one year in health-related work, LICSW preferred, and a passion for community-based care. A driver’s license and ability to travel within Upper Valley area are expected.