The Hospice Care Coordinator – Social Worker plays a meaningful role in helping patients and families navigate one of life’s most important transitions. As one of the first points of contact for families considering hospice, you will provide compassionate guidance, education, and support while helping connect patients with the care and resources they need.
This position combines social work, counseling, care coordination, and relationship-building to support patients and families from the initial hospice consultation through admission. You will conduct in-person and virtual consultations, assess psychosocial needs, educate families about hospice services, and help them make informed decisions that honor their goals, values, and wishes.
The Care Coordinator is also responsible for coordinating the referral-to-admission process, working closely with referral sources, admissions nurses, and the hospice interdisciplinary team to help ensure a smooth and timely transition into hospice care.
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Respond to hospice consult requests from hospitals, nursing facilities, physicians, and internal referral sources.
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Conduct timely in-person and virtual consultations with patients and families to introduce hospice services and support eligibility discussions.
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Educate patients and families on the hospice philosophy, available services, coverage, and the interdisciplinary approach to care.
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Complete psychosocial assessments to identify patient and family needs, strengths, concerns, and barriers to care.
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Provide compassionate emotional support, active listening, and crisis intervention during periods of uncertainty, transition, or distress.
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Help patients and families understand their prognosis and care options while respecting their cultural, spiritual, and personal values.
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Support families with concerns related to caregiver burden, family dynamics, advance directives, financial hardship, grief, and other psychosocial needs.
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Connect patients and families with appropriate community resources, including financial assistance, transportation, spiritual support, respite services, and other available resources.
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Serve as a liaison between referral sources and the hospice team to promote seamless transitions of care.
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Collaborate with admissions nurses and the hospice interdisciplinary team to facilitate timely and appropriate admissions.
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Communicate psychosocial findings and recommendations to the interdisciplinary team to promote continuity and coordination of care from the very first encounter.
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Promote patient autonomy, dignity, and self-determination by supporting informed decision-making.
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Build and maintain strong, positive relationships with referral partners, including hospitals, skilled nursing facilities, physicians, and clinics.
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Participate in team meetings and contribute ideas to strengthen and improve the consult and intake process.
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Maintain accurate documentation of assessments, communications, and interventions in accordance with agency policies and regulatory requirements.
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Remain current on hospice regulations, best practices, and available community resources.
As part of the hospice consultation process, the Social Worker provides a compassionate presence for patients and families who may be facing difficult decisions and uncertain circumstances. Through thoughtful assessment, counseling, education, and resource coordination, you will help families understand their options and feel supported throughout the decision-making process.
You will have the opportunity to:
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Assess psychosocial needs and identify strengths, concerns, and barriers affecting the patient and family.
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Provide meaningful emotional support and counseling during a critical time.
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Help families navigate difficult conversations, caregiver concerns, family dynamics, financial challenges, grief, and advance care planning.
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Connect patients and families with resources that can ease practical and emotional challenges.
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Advocate for patient dignity, choice, and quality of life.
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Work alongside an interdisciplinary hospice team to ensure patients and families receive coordinated, compassionate care from their very first encounter.
Every hospice journey is different. In this role, your ability to listen, educate, advocate, and connect families with the right resources can make a lasting difference. You will have the opportunity to use your social work expertise in a role where compassion, communication, and meaningful patient advocacy are at the heart of what you do.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those stated in this description.
Master’s Degree in Social Work (MSW) from an accredited program required.
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Minimum of 2 years’ experience in hospice, palliative care, medical social work, or care coordination preferred.
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Strong interpersonal skills and ability to communicate effectively and compassionately with patients, families, and healthcare professionals.
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Comfortable discussing sensitive end-of-life issues and guiding families through complex decisions.
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Ability to work independently, manage multiple consults, and prioritize urgent needs.
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Proficient with electronic documentation and scheduling systems
Suburban Hospice is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Suburban Hospice is committed to equal employment opportunity for all employees and to providing employees with a work environment free of discrimination, harassment, and workplace violence. All employment decisions at Suburban Hospice are made based on job requirements, individual qualifications, or business need without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristics under applicable law. Suburban Hospice creates a culture with zero tolerance for discrimination or harassment and seeks an environment of inclusion and respect at work.
