The Medical Social Worker is responsible for carrying out care coordination of the assigned patient population during the episode of care to ensure safe and effective outcomes across the continuum of care. The Medical Social Worker oversees interdisciplinary activity and the discharge planning process relevant to managing the high risk, maternity and newborn, and emergency department patient populations of Southwest General Health Center. This will include demonstrating the knowledge and skills necessary to provide services appropriate to age groups according to specific chronological age, developmental age, and/or psycho-social maturity. Scope of practice includes patients in the age range of newborn to 100+ years of age. In this process, they assimilate individual, social, medical, and physical information. The Medical Social Worker position will facilitate creating a safe and effective discharge plan associated with patient/family healthcare goals that is timely and provides high quality social work services. Specific duties include assessing and screening patients for discharge needs, performing readmission prevention activities, coordinating and providing referrals for continuing care, and locating available community resources for patients.
