What are the responsibilities and job description for the Social Worker - CW Care Management - Children's and Women's Hospital position at University of South Alabama Health System?
ID: 2026-22543
Category: Professional
Position Type: Regular Full-Time
Shift: 8:00am-4:00pm, rotating on call 4:30pm-8:00am
Performs initial discharge planning assessments in a timely manner from time of patient admission, evaluating baseline function versus anticipated discharge needs. Follows Mandatory Reporting guidelines for abuse, neglect, exploitation & collaborates with associated agencies. Collaborates & communicates with physicians, bedside nurses, utilization management staff, therapy services, and associated clinical professionals to facilitate effective transitions to the next level of care. Participates in interdisciplinary patient care rounds and conferences; communicates discharge plans as part of rounds. Establishes and supports patient-centered and provider goals to determine next steps for a positive patient experience and well-coordinated transition of care. Reassesses discharge needs based on changes in patient condition or plan of care and discusses updates with patients and families/caregivers. Provides the patient and family resources based upon his/ her insurance options and helps them to formulate an individual discharge plan based upon their needs. Provides individualized discharge planning by: Acting as a resource for patient/family Assisting with medication access Arranging transportation Coordinating durable medical equipment (DME) Facilitating home health services Arranging hospice care Coordinating rehabilitation, skilled nursing, long-term care placement, and facility transfers Assisting with Veteran’s Administration and discharge needs Referring to mental health facilities Supporting probate and commitment processes as appropriate Sends referrals to appropriate post-acute agencies to support safe discharge and continuity of care. Ensures that, upon finalization of the discharge plan, medications, equipment, and transportation are in place. Evaluates social determinants of health and identifies differences between initial assessment findings and discharge needs. Provides resources and referrals to address identified barriers and reduce the risk of readmission. Performs timely readmission assessments when applicable; initiates referrals and services aimed at preventing future readmissions. Collaborates with outside agencies and community case management programs to develop individualized plans of care. Documents all assessments, discharge plans, referrals, interventions, and actions performed in the medical record according to department policy. Documents avoidable delays to support leadership in identifying performance improvement opportunities. Abides by and enforces all compliance requirements and hospital policies, including confidentiality, while performing duties ethically and in alignment with organizational values. Performs timely intervention related to discharge planning assessment and consults placed for patients as identified by a healthcare team member having urgent social or discharge planning needs. Enhances professional growth and development through participation in educational programs. Participates in committees and performance improvement activities, or other quality initiatives as assigned. Maintains professional practice in accordance with the National Association of Social Workers (NASW) Code of Ethics, hospital policies, applicable laws and regulations, and standards of professional conduct. Screens for indicators of abuse, neglect, domestic violence, human trafficking, and exploitation during discharge planning assessments. Provides immediate intervention when safety concerns are identified, prioritizing patient protection and stabilization. Serves as a mandated reporter and ensures compliance with all applicable child welfare, adult protective services, and vulnerable population reporting laws. Coordinates with physicians, nursing, care management, security, legal counsel, and risk management to support investigation, reporting, and care planning. Educates patients and families on available protective resources and support services when appropriate. Maintains strict confidentiality and professional documentation standards related to sensitive reporting and investigations. Demonstrates the ability to provide competent patient care to implement an effective discharge plan to the following patient populations: neonate, pediatric, adolescent, adult, and geriatrics. Requires minimal supervision to perform essential job functions. Maintains regular and prompt attendance. Works assigned schedule and overtime as required. Performs mandatory after hour on-call and weekend coverage as assigned. Utilizes proper body mechanics while performing job duties. Completes all mandatory department, educational and hospital requirements Adheres to current Infection Control and Safety Standards Regular and prompt attendance Ability to work schedule as defined and overtime as required Related duties as assigned Master's Degree in social work from an accredited institution Required OR Bachelor's Degree in social work from an accredited institution and 2 years of social work experience Required OR Bachelor's Degree in a related field from an accredited institution and 3 years of social work experience Required Licensure with the State of Alabama as a Social Worker. Required Comparable combination of education and experience may substitute for the above requirements. Knowledge, Skills, and Abilities
Overview
USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education, and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists, and researchers provides the region's most advanced medicine at multiple facilities, campuses, clinics, and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall well-being of our community.Responsibilities
Additional Information
Employees must be in a regular position, working 20 hours or more per week (.50 FTE or greater) to qualify for benefits.Qualifications
- Acute Care Management/Discharge Planning experience preferred Acute Care Management/Discharge Planning experience preferred
- Pediatric and/or Maternal Health patient population experience preferred Pediatric and/or Maternal Health patient population experience preferred
Equal Employment Opportunity Employer
The University of South Alabama is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, religion, age, genetic information, disability, protected veteran status or any other applicable legally protected basis. EO Employer – minorities/females/veterans/disabilities/sexual orientation/gender identity.