MSW Transitional Care: Discharge & Care Coordination

Alaska Native Tribal Health Consortium (ANTHC); Anchorage (AK); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Medical Insurance

401(a) Retirement Plan

Paid Time Off

Tuition Discounts

Job summary

Alaska Native Tribal Health Consortium (ANTHC) seeks a Social Worker to lead proactive care planning and transition support across acute and post-acute settings in Alaska. You will collaborate with medical providers, patients, and families to promote wellness and satisfaction through care transitions.

With a Master’s in Social Work and 2+ years of non-supervisory experience, you will drive discharge planning, care coordination, and patient advocacy while navigating diverse communities and tribal

Qualifications

• Master’s Degree in Social Work.
• Two years of non-supervisory experience in social work.
• Current Basic Life Support (BLS) certification.

Responsibilities

• Identify care management patients by accessing ED or inpatient services and establish contact within 24 hours of referral.
• Create and coordinate transitional and discharge plans for chronic, high-risk patients.
• Conduct concurrent medical record reviews to measure progress toward discharge goals.
• Prepare and present cases for discussion at scheduled meetings.
• Coordinate interventions, treatments and procedures to meet patient needs during inpatient care and ensure clear communication among providers.

Skills

Care coordination

Interdisciplinary teamwork

Cultural competency

Patient advocacy

Proactive care planning

Education

Master’s Degree in Social Work

Tools

EHR systems

Job description

Alaska Native Tribal Health Consortium (ANTHC) seeks a Social Worker to lead proactive care planning and transition support across acute and post-acute settings in Alaska. You will collaborate with medical providers, patients, and families to promote wellness and satisfaction through care transitions.

With a Master’s in Social Work and 2+ years of non-supervisory experience, you will drive discharge planning, care coordination, and patient advocacy while navigating diverse communities and tribal