Social Worker

We are seeking a skilled Social Worker to join our team as a Psychosocial Complex Patient Care Coordinator. In this role, you will work closely with patients, caregivers, and healthcare teams to provide comprehensive care and support to individuals with complex psychosocial needs.

• Conduct thorough psychosocial assessments to identify patient needs and develop personalized care plans.
• Collaborate with interdisciplinary teams to coordinate discharge planning, ensuring a smooth transition of care for patients.
• Provide emotional, social, and financial support to patients and caregivers, connecting them with community resources and services as needed.
• Advocate for patient empowerment and independence, promoting autonomy in healthcare decision-making.
• Document all findings and interventions in the electronic medical record (EMR).
• Develop therapeutic relationships with patients and caregivers, gathering psychosocial and SDOH information to inform discharge planning.
• Identify patients at risk for readmission and develop strategies to prevent unnecessary hospitalizations.
• Participate in Daily Transition Rounds (DTRs) to discuss discharge needs and identify transitional care barriers.
• Collaborate with the care team to develop comprehensive, patient-centered care plans, reassessing patients as needed.
• Escalate care progression and coordination concerns as necessary, following facility-specific acceleration channels.

• BSW or higher degree; will consider a limited license SW on an individual basis.
• Knowledge of regulations, requirements, and community resources.
• Ability to function effectively in a critical care environment.
• Excellent interpersonal communication and negotiation skills.
• Critical thinking and problem-solving skills.
• Customer service skills.
• Ability to work and communicate with people of all social, economic, and cultural backgrounds.

• MSW degree.
• Applicable experience in patient advocacy, care management, and knowledge of hospital and community resources.
• Previous case management or discharge planning experience.
• Specialty certification in care management (CCM, ACM, or similar).

This role requires the ability to stand for long periods of time and work rapidly for extended periods. ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio.

We are an equal opportunity employer and welcome applications from diverse candidates. If you have a disability and require an accommodation to apply for this role, please contact us.