At NorthBay Health the Medical Social Worker - Hospital provides direct clinical social work service, counseling, discharge planning, and case management services to hospital patients and their families including assessment and documentation of emotional, social, financial, environmental or follow-up referral needs. Works collaboratively with the interdisciplinary healthcare team. Formulates a psychosocial plan of care related to assessment of patients unique strengths and needs. Develops a discharge plan for case load as designated by the team. Monitors progress toward goals of care and identifies barriers to meeting estimated length of stay. Facilitates integration with community-based resources to optimize patient health. Activities are consistent with System mission and values and in compliance with applicable regulations and System policies and procedures.