Social Work Case Manager

UVA Health; Virginia (IL); On-site; USD 58,000 - 93,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Paid Time Off

Health Saving Plans

Certification and education support

Generous Paid Time Off

Job summary

UVA Health in Charlottesville, VA is seeking a Social Work Case Manager to identify patients and families needing coordination of continuing care, review records, attend rounds, and respond to patient needs with a focus on psychosocial barriers and social determinants of health.

You will collaborate with the care team to develop and implement discharge plans, navigate post-acute options, and lead family meetings to support timely, appropriate transitions.

Qualifications

• MSW is required or LMSW/LCSW preferred.
• At least one year of discharge planning experience in acute or subacute settings.
• Experience as a Medical Social Worker with documented success.

Responsibilities

• Identify patients/families needing coordination of continuing care or community support.
• Review medical records, attend rounds, respond to patient needs and apply professional standards.
• Lead discharge planning with the care team to ensure safe, timely transitions across settings.

Skills

Discharge planning experience

Medical Social Work knowledge

Education

Master's degree in Social Work (MSW)

LCSW/LMSW preferred

Job description

In support of patient progression practice, create optimal outcomes for the patient and the family by managing complex psychosocial and economic barriers to patient progression. Through advanced practice skills, mobilize resources to reduce risk to the patient and families secondary to social determinant based needs and challenges. Provide patient support with cultural humility to ensure that interventions by the care team are rendered respectfully to diverse populations. Join UVA Health as a Social Work Case Manager.

What can I expect to do in this role?

At UVA Health, a Social Work Case Manager

• Identifies patient and/or families requiring coordination of continuing care or community support members of the care team. Reviews medical records, attends rounds, and responds to patient’s needs. Applies knowledge based on professional experience.
• Understands and adheres to the practice standards consistent with patient progression and its contribution to the strategic plan.
• Works collaboratively with the RN Case Manager and the treatment team members to develop and coordinate a safe, timely and appropriate discharge plan across the care continuum, addressing psychosocial barriers, with multiple resource dependent level of care options that comply with regulations and laws regarding patient/family participation with planning and choice.
• Coordinates post-acute discharges for complex patients in collaboration with Care Management Discharge Manager.
• Identifies the need for and conducts in a timely fashion patient family meetings that result in decisions regarding advance directives, comfort measures, power of attorney, guardianship, conservatorship, and goals of care.
• Completes initial psychosocial screen of patients and families as indicated. Serves as the lead in addressing psychosocial needs of patients relating to social determinants of health, barriers to equal access to healthcare, and patient progression; this includes obtaining charity and financial resources, legal guardianship, adoptions, psychiatric referrals, and competency determination.
• Provides referrals for post-acute transitions to/for LTACH, SNF, IRF, LTC , HH and DME.
• Conducts practice consistent with social work ethical principles, adhering to standards set forth from NASW and ACMA Case Management practice standards.
• Identifies the need for and conducts family meetings that result in comfort, treatment and discharge planning decisions, and other important outcomes.
• Leads Care Coordination/Interdisciplinary Rounds and documents.
• Advocates for patient care and timely discharge plan.
• Works with people and agencies in the community to improve responsiveness, capabilities, alignment, and evaluation of services to patients and families.
• Utilizes age-appropriate assessments and interventions during all client contacts.
• Collaborate with Risk Management, Patient Relations, Utilization Management, the Ethics Committee and other departments for ethical issues and utilizes the NASW Code of Ethics in appropriate decision‑making.
• Demonstrates flexibility and partnership with the care management team members to ensure the needs of patients are met.
• Assists patients and families in understanding their illness and treatments options, consequences to various treatments or refusal of treatment, and necessary levels of care, including acute, subacute, and community services.
• Assists patients and families in communicating with treatment team
• Educates hospital staff on patient psychosocial needs.
• In addition to the above job responsibilities, other duties may be assigned.

What is UVA Health looking for in its next Social Work Case Manager?

If You Can Demonstrate

• qualifications as an MSW, or optimally, an LMSW/LCSW;
• at least one year of experience performing discharge planning in an acute or subacute setting; and
• documented success as a Medical Social Worker

Why UVA Health?

UVA Health is one of the nation's leading academic health systems, bringing together advanced clinical care, innovation, education, and research in support of exceptional patient outcomes.

Why People Love Living in Charlottesville

Nestled at the foothills of the Blue Ridge Mountains, Charlottesville offers an exceptional quality of life that attracts healthcare professionals from across the country. Residents enjoy easy access to hiking, biking, wineries, outdoor recreation, and breathtaking scenery while benefiting from the cultural energy of a vibrant university community. The area features outstanding dining, arts, music, and family-friendly neighborhoods, along with a more manageable pace of life than many major metropolitan regions. For professionals seeking a balance between career growth and personal well‑being, Charlottesville provides an outstanding place to build both a rewarding career and a fulfilling life.

Minimum Requirements

Education: Master's degree in Social Work from a CSWE accredited social work program required.

Experience: No relevant experience required; Experience in the social work field; experience in health care settings is preferred.

Licensure: Expectation to become Licensed Clinical Social Worker (LCSW) guidelines found in departmental addendum located in department competency file.

PHYSICAL DEMANDS

Job requires sitting for prolonged periods, standing/traveling or use of assistive and climbing (stairs, steps). Proficient communicative, auditory and visual skills; Attention to detail, hear, speak, see, distinguish colors, read, ability to write legibly; Ability to lift/push/pull less than 20lbs. May be exposed to chemicals, blood/body fluids and infectious disease.

The pay range for this role is $57,907.20 - $92,643.20 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
• Paid Time Off, Long‑term and Short‑term Disability, Retirement Savings
• Health Saving Plans, and Flexible Spending Accounts
• Certification and education support
• Generous Paid Time Off

UVA Health is a world‑class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children’s hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. Learn more about UVA’s commitment to non‑discrimination and equal opportunity employment.