MSW Social Worker — Transition of Care & Coordination

Prominence Health; Reno (NV); Hybrid; USD 60.000 - 90.000; Vollzeit

Benefits dieser Stelle

Loan Forgiveness Program

Challenging and rewarding work enviro

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and

401(K) with company match

Zusammenfassung

Prominence Health is seeking a Social Worker to collaborate with the interdisciplinary care team and facilitate safe transitions from hospital to home for members. The role focuses on using the social work model to improve post-discharge outcomes and reduce readmissions, with outreach in outpatient settings to connect needed resources.

The position emphasizes TOC program protocols, inpatient and post-discharge workflows, and patient/caregiver education on resources and care planning.

Qualifikationen

• Master’s Degree in Social Work required.
• Active LCSW in NV, TX, or FL or ability to obtain licensure in multiple states.
• Experience with Medicare/Medicaid populations and post-discharge care coordination.

Aufgaben

• Collaborate with interdisciplinary care team to facilitate transitions from acute/post-acute care to home.
• Engage with outpatient members to connect resources and reduce readmissions.
• Identify discharge barriers and educate members and caregivers about post-discharge needs.
• Promote care coordination and participate in SNP CM program implementation.

Kenntnisse

English communication

Spanish communication

Tagalog communication

Project management

Ausbildung

Master’s Degree in Social Work

Tools

Smartsheet

SharePoint

Microsoft Office

Database software

Jobbeschreibung

Prominence Health is seeking a Social Worker to collaborate with the interdisciplinary care team and facilitate safe transitions from hospital to home for members. The role focuses on using the social work model to improve post-discharge outcomes and reduce readmissions, with outreach in outpatient settings to connect needed resources.

The position emphasizes TOC program protocols, inpatient and post-discharge workflows, and patient/caregiver education on resources and care planning.