SOCIAL WORKER REHAB UNIT FT

PSN Services LLC•Carrollton, TX

About The Position

The Master’s Social Worker (MSW) provides essential psychosocial support, discharge planning, and case management services to patients and their families in an inpatient rehabilitation setting. The MSW collaborates with an interdisciplinary team to ensure comprehensive care, addressing emotional, social, and environmental barriers to recovery. This role involves conducting assessments, facilitating family meetings, coordinating post-discharge services, and advocating for patient needs to optimize outcomes.

Requirements

Education: Master’s degree in Social Work (MSW) from an accredited program.
Licensure: Current state LSW/LMSW licensure (LCSW preferred in some states).
Experience: 1+ years in healthcare (rehab, hospital, or acute care preferred).
Skills:
Knowledge of Medicare/Medicaid, insurance systems, and post-acute care resources.
Strong crisis intervention, advocacy, and communication skills.
Ability to work in a fast-paced, interdisciplinary environment.

Responsibilities

Case Management & Care Coordination
Serve as a primary case manager for assigned patients, overseeing the progression of care from admission to discharge.
Conduct utilization reviews in collaboration with the rehab team to ensure medical necessity and insurance authorization for continued stay.
Monitor patient progress, identify barriers to recovery, and adjust care plans as needed.
Coordinate with physicians, nurses, therapists, and external providers to optimize treatment outcomes.
Facilitate interdisciplinary team meetingsto discuss patient goals, discharge readiness, and post-acute needs.
Psychosocial Assessment & Intervention:
Conduct comprehensive psychosocial evaluations to identify patient needs, support systems, and barriers to recovery.
Provide counseling, crisis intervention, and emotional support to patients and families.
Address mental health concerns, adjustment to disability, grief, and coping strategies.
Discharge Planning & Care Coordination:
Develop and implement individualized discharge plans in collaboration with the rehab team.
Arrange post-acute services (e.g., home health, skilled nursing facilities, outpatient therapy).
Coordinate with community agencies, insurers, and vendors to secure resources (DME, housing, financial assistance).
Interdisciplinary Collaboration:
Participate in team meetings, contributing insights on psychosocial factors affecting rehabilitation.
Advocate for patient needs and ensure continuity of care across transitions.
Educate staff on cultural, familial, or socioeconomic considerations impacting treatment.
Documentation & Compliance:
Maintain timely, accurate records in compliance with hospital policies and regulatory standards (CMS, Joint Commission).
Complete necessary documentation for insurance authorizations and level-of-care updates.
Patient & Family Education:
Provide education on community resources, advance directives, and long-term care options.
Facilitate family/caregiver training to support patient independence and safety post-discharge.