The Social Worker facilitates care across the continuum through effective resource coordination, helping patients achieve optimal health, access care, and use resources appropriately while respecting patients’ resources and right to self-determination. The role ensures care is provided at the appropriate level based on medical necessity and assesses transition needs to support timely throughput, safe discharge, and prevention of avoidable readmissions. It conducts complex psychosocial assessment and intervention and integrates national standards for case management services, including transition management, care coordination, regulatory compliance, education, and collaboration with community providers. The position coordinates care and assesses and reassesses transition needs, including complex psychosocial needs. It implements or oversees transition and discharge plans, assists with adoption, abuse, and neglect cases, and leads or facilitates multidisciplinary patient care conferences, including Complex Case Review. The Social Worker makes referrals, communicates care plans to patients and families, collaborates with physicians and other care teams, supports patient education for post-acute needs, maintains timely and accurate documentation and patient demographic and insurance information, precepts and supports staff, facilitates TEMPO as needed, and participates in quality improvement initiatives. Doctors Medical Center of Modesto is described as a 394-bed general acute care hospital with a 67-bed inpatient psychiatric capacity, offering inpatient, outpatient, and emergency care across a range of specialties and services.
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Job Type
Full-time