MSW Social Worker

MSW Medical Social Worker
Greater Orlando Area, Florida

The MSW, Medical Social Worker, receives referrals for individuals from at-risk populations from interdisciplinary team members. The Medical Social Worker ensures patient-centered Care Coordination through the Continuum of Care. The MSW ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The MSW is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post-hospital needs, development of a transition of Care Plans and initiation of the implementation of the transitions of Care Plans prior to the discharge of the patient.

The MSW is responsible for optimal patient flow/throughput to enhance Continuity of Care, smooth and safe transitions, patient satisfaction, patient safety, readmission prevention and length of stay management. The Clinical Social Worker, Licensed, communicates daily with the interdisciplinary team during daily multidisciplinary rounds. Care coordination, discharge planning, transitions of care planning and are core competencies. The MSW facilitates the collaborative management of patient care across the continuum.

The MSW intervenes with patients who have complex psychosocial needs, require assistance with eligibility determination for social programs, funding sources and qualify for community assistance from a variety of special assistance programs and agencies, and/or require assistance with Transitions of Care or Discharge Planning.

The MSW provides education to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning, and Care Coordination. The Clinical Social Worker, Licensed, is knowledgeable of post-hospital care and services available to the patient.

Qualifications:

• Masters in Social Work (MSW) experience in an Acute Hospital setting
• Licensed Clinical Social Worker (LCSW) or Licensed Clinical Social Worker Associate (LCSW-A)
• Care Management discharge planning experience in a fast-paced Acute Hospital setting
• Knowledge of state and federal guidelines pertinent to Medical Case Management
• Acute Hospital Experience in Medical Social Work Case Management

Responsibilities:

• Escalates issues barriers to appropriate level of Care Management leadership
• Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan
• Proactively identifies patients who no longer meet medical necessity and escalates potential denials, documents avoidable days, and facilitates progression of care
• Collaborates with Utilization Management staff for collaboration on patient status changes and medical necessity discussions
• Ensures all patients on assigned unit(s) are moved timely and effectively to appropriate levels of care
• Ensures reassessment of discharge needs provided anytime a patient’s condition changes and/or the circumstances impacting the provision of post-hospital care changes
• Serves as a resource to provide information and intervention related to treatment decisions, terminal illnesses and end-of-life issues
• Provides grief counseling and crisis intervention skills
• Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the Healthcare System
• Provides de-escalation services for patient/family as appropriate
• Provides Motivational Interview techniques for patients with substance use and addictive disorders
• Provides patient/family education, adjustment-to-illness counseling, grief counseling and crisis intervention
• Provides education to patients/families/caregivers regarding resource options and coping with diagnosis, treatment and prognosis
• Works in collaboration with hospital and community agencies to obtain needed services and resources for patients/families/caregivers
• Provides assessment and reporting interventions
• Provides consultation services for patients who may possibly lack decision making capacity
• Follows the guardianship (temporary/ permanent) policies and procedures and coordinates with Care Management leadership throughout the process
• Facilitates full team discussion including patient and family when ethical dilemmas arise
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization

For our Case Management opportunities, feel free to forward a resume to Michelle Boeckmann at [email protected] or visit our Case Management website at

If this opportunity is of interest or know someone that would have interest, please feel free to contact me at your earliest convenience.

Michelle Boeckmann | President Case Management Recruitment
Direct Dial 615-465-0292

[email protected]

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