Social Worker: Home & Facility Care Coordination

Your Health Organization; Brunswick (GA); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive Compensation Package with

Employer Matched 401K

Free Visit & Prescriptive Serviceswith

Employer Matched HSA

Generous PTO Package

Job summary

Your Health Organization in Brunswick, GA is seeking a qualified Social Worker to assist our patients across care facilities and home visits. The role requires compassionate service and coordination with care teams.

Responsibilities include advancing advance care planning, daily assessments and care plans, discharge coordination, and maintaining referrals and communications with patients and families. This full-time role involves 8-hour shifts Mon-Fri with travel across the Brunswick area.

Qualifications

• Initiating Advance Care Planning for patients throughout their assigned Care Team (including facilities).
• Completing Daily Comprehensive Assessments on patients.
• Completing Daily Care Plans on patients.
• Documenting Chronic Care Management time daily.
• Meeting Daily Productivity Goals.
• Coordinating discharges at contracted facilities.
• Coordinating Placement.
• Continuation of coverage (i.e. coordinating acute visits for falls, med changes, etc.).
• Build and maintain professional relationships with referral sources.
• Maintain strong communication and professionalism between referral sources, patients/families, and Care Teams.

Responsibilities

• Initiating Advance Care Planning for patients throughout their assigned Care Team (including facilities).
• Completing Daily Comprehensive Assessments on patients.
• Completing Daily Care Plans on patients.
• Documenting Chronic Care Management time daily.
• Meeting Daily Productivity Goals.
• Coordinating discharges at contracted facilities.
• Coordinating Placement.
• Continuation of coverage (i.e. coordinating acute visits for falls, med changes, etc.).
• Build and maintain professional relationships with referral sources.
• Maintain strong communication and professionalism between referral sources, patients/families, and Care Teams.

Job description

Your Health Organization in Brunswick, GA is seeking a qualified Social Worker to assist our patients across care facilities and home visits. The role requires compassionate service and coordination with care teams.

Responsibilities include advancing advance care planning, daily assessments and care plans, discharge coordination, and maintaining referrals and communications with patients and families. This full-time role involves 8-hour shifts Mon-Fri with travel across the Brunswick area.