Social Worker II, AHWFB

Advocate Aurora Health; Winston-Salem (NC); On-site; USD 55,000 - 75,000; Full time

Job summary

Advocate Health in Winston-Salem seeks a Social Worker II to provide comprehensive psychosocial assessments, discharge planning, and care coordination for patients and families. You will collaborate with the care team to identify needs, refer to community resources, and support transitions to post-discharge care.

The role requires an MSW from a CSWE-accredited program, strong communication and advocacy skills, and the ability to work in a fast-paced hospital setting.

Qualifications

• Master's Degree in Social Work (MSW) from a CSWE-accredited program.
• Strong clinical skills and knowledge of discharge planning and care coordination.
• Ability to collaborate with a multidisciplinary team to support patient outcomes.

Responsibilities

• Identify patients needing case management services during discharge planning.
• Complete psychosocial assessments evaluating emotional, social, environmental, and financial needs.
• Develop, implement, and monitor psychosocial treatment plans.
• Provide crisis intervention and counseling to patients and families.
• Coordinate referrals to community resources and services.
• Advocate for patients to address barriers to care.
• Collaborate with physicians, nurses, and team members to support discharge planning.
• Coordinate and facilitate patient and family care conferences as needed.
• Guide patients through post-discharge options and resources.
• Maintain knowledge of regulations affecting patient care and discharge planning.
• Document assessments and plans in the electronic medical record.

Skills

Age-appropriate care

Assessment skills

Communication skills

Counseling skills

Advocacy skills

Conflict management

Prioritization

Adaptability

Care coordination knowledge

Education

MSW CSWE-accredited

Job description

The Social Worker II provides social work services, complex discharge planning and care coordination to patients and families. This role identifies needed community services and refers patients in need to the appropriate services and communicates any psycho-social issues that may impact the health or condition of the patient with other hospital staff. As a Social Worker II, you will collaborate with members of the multi-disciplinary team to affect positive patient and family outcomes.

Education & Experience

Required

• Master's Degree in Social Work (MSW) from a program accredited by the Council on Social Work Education (CSWE).

Preferred

• Social work experience in a healthcare setting.

Licensure, Certification & Registration

Preferred

• Clinical licensure or provisional clinical licensure.
• Accredited Case Manager (ACM-SW) certification.

Key Responsibilities

• Identify patients who may benefit from case management services through assessment of discharge planning and care coordination needs.
• Complete comprehensive psychosocial assessments to evaluate emotional, social, environmental, and financial needs.
• Develop, implement, and monitor individualized psychosocial treatment plans.
• Provide crisis intervention, supportive counseling, family counseling, grief support, and other appropriate social work interventions.
• Coordinate internal and external referrals to community resources and support services.
• Advocate for patients and families to address unmet needs and remove barriers to care.
• Collaborate with physicians, nurses, and interdisciplinary team members to support patient progression and discharge planning.
• Coordinate and facilitate patient and family care conferences as needed.
• Guide patients and families through available post-discharge care options and resources.
• Maintain knowledge of federal, state, and local regulations affecting patient care and discharge planning.
• Stay informed on payer requirements and reimbursement practices that impact the plan of care.
• Identify barriers to efficient care delivery and implement strategies to improve outcomes.
• Document assessments, interventions, and care plans in the electronic medical record according to departmental and regulatory standards.

Qualifications & Skills

• Ability to provide age-appropriate and developmentally appropriate care.
• Strong assessment, communication, counseling, and advocacy skills.
• Ability to build positive working relationships and effectively manage conflict.
• Demonstrated ability to prioritize responsibilities and work effectively in a fast-paced environment with frequent interruptions.
• Adaptability and resilience in a rapidly changing healthcare environment.
• Strong knowledge of community resources, discharge planning processes, and care coordination.