MSW Medical Master Social Worker
Celebration, 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 Medical 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 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 Medical Master Social Worker, Licensed, is knowledgeable of post-hospital care and services available to the patient.
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For our Case Management opportunities, feel free to forward a resume to Michelle Boeckmann at [email protected] or visit our Case Management website at
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