Social Worker

Johns Hopkins Medicine; Baltimore (MD); On-site; USD 55,000 - 70,000; Full time

Job summary

Johns Hopkins Medicine is seeking a Social Worker I to collaborate with patients, families, and the care team. The role emphasizes psychosocial assessment, counseling, care coordination, and discharge planning to address barriers to care.

Responsibilities include direct support, community resource connections, and participation in interdisciplinary rounds, with a focus on timely documentation and patient-centered planning.

Qualifications

• MSW required.
• Maryland LMSW licensure required.

Responsibilities

• Screen patients and perform psychosocial assessments.
• Provide direct psychosocial support, care coordination, and discharge planning.
• Collaborate with the interdisciplinary team to support care progression and outcomes.
• Develop plans to address psychosocial barriers to discharge.
• Maintain accurate documentation in line with standards.
• Connect patients with community resources and referrals as needed.
• Participate in team rounds and quality improvement activities.

Skills

Interpersonal skills

Collaboration

Communication

Time management

EMR proficiency

Education

MSW

Tools

Electronic Medical Records

Job description

Social Worker

Summary

In collaboration with patients, families, case managers, physicians, and the interdisciplinary team, the Social Worker I provides psychosocial assessment, counseling, care coordination, and discharge planning. This role identifies barriers to care, connects patients with community resources, supports transition planning, and uses clinical interventions to address immediate patient and family needs.

Essential Functions

• Screen patients for social work needs and complete full psychosocial assessments as needed.
• Provide direct psychosocial support, care coordination, and transition planning for assigned patients.
• Collaborate with the interdisciplinary team to support care progression and optimize patient outcomes.
• Develop and implement plans to address psychosocial barriers to discharge.
• Maintain timely, accurate documentation in accordance with departmental and regulatory standards.
• Connect patients and families with appropriate community, local, regional, and national resources.
• Assist with referrals for guardianship, adoption, psychiatric services, abuse/neglect/IPV concerns, end-of-life issues, and charity care.
• Facilitate family meetings and participate in interdisciplinary rounds as needed.
• Participate in quality improvement activities, committee work, and coverage for absences/vacancies.
• Provide on-call coverage and home visits as required.
• Complete supervision as required by COMAR regulations.
• Perform other duties as assigned.

Additional Responsibilities: Community Psychiatry Program (CPP) SW I

• Provide psychotherapy and psychosocial care for assigned patients.
• Support patient/family engagement, education, crisis intervention, grief counseling, and mandated reporting as needed.
• Monitor medication effectiveness, observe for side effects, and notify the physician of concerns or needed changes.

Qualifications

Education:

• MSW required

Licensure:

• Maryland LMSW required

Knowledge, Skills, and Abilities:

• Strong interpersonal and collaboration skills
• Knowledge of community resources
• Ability to gather, synthesize, and communicate relevant patient information
• Excellent written and verbal communication skills
• Strong time management and prioritization skills
• Proficiency with electronic medical records, email, and standard office technology