Social Worker: Discharge Planning & Care Coordination

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 60,000 - 85,000; Full time

Job summary

Cape Fear Valley Medical Center in Fayetteville, NC seeks a Social Work professional to plan services for targeted populations, conduct psychosocial assessments, crisis intervention, and discharge planning. You will coordinate referrals and resources, advocating for patients and families as they navigate environmental stress, illness, and care needs across the continuum.

Collaborating with nursing and staff, you will ensure patient needs are met and care is coordinated at the appropriate level

Qualifications

• Bachelor’s degree in Social Work required.
• MSW preferred.
• CSW, CCM, or ACM certifications preferred.
• 3 years’ experience in Social Services, Home Health, Hospice or Acute Care setting required.
• Acute Care Case Management experience preferred.
• Proficiency with Microsoft Office and clinical IT systems.

Responsibilities

• Conducts face-to-face interviews with patients and families to develop therapeutic relationships and obtain psychosocial and financial information for discharge planning.
• Performs proactive screenings and assessments for clinical, psychosocial, and discharge planning needs.
• Documents assessment, plan, progress, interventions, and reassesses as needed.
• Initiates referrals and recommends consults for safe, timely discharge or transfer.
• Assists patient/family in coping with hospitalization, disability, and chronic/terminal illness.
• Provides information and education on community resources and post-acute care options.

Skills

Interpersonal communication

Negotiation skills

Time management

Organizational skills

Discharge planning

Education

Bachelor’s degree in Social Work

MSW preferred

CSW/ CCM/ ACM certifications preferred

Tools

Microsoft Office

Midas

ProviderLink

ValleyLink

eHIM

SMS

Job description

Cape Fear Valley Medical Center in Fayetteville, NC seeks a Social Work professional to plan services for targeted populations, conduct psychosocial assessments, crisis intervention, and discharge planning. You will coordinate referrals and resources, advocating for patients and families as they navigate environmental stress, illness, and care needs across the continuum.

Collaborating with nursing and staff, you will ensure patient needs are met and care is coordinated at the appropriate level