As a per diem Medical Social Worker, you will provide psychosocial support, assessment, and care coordination to patients and families receiving services in the home. The role addresses emotional, social, financial, and environmental factors that affect health and recovery while supporting safe and effective care transitions. You will collaborate with the interdisciplinary team to connect patients with community resources and provide counseling. You will assist patients and families with health-related concerns, provide social work services according to the plan of care, and educate patients, families, and team members about medical social work interventions and the treatment plan. You will also coordinate care planning, transfers, and discharges, and identify and address risks in the patient's environment in coordination with the physician and other healthcare team members.