Evaluate and address barriers such as complex clinical needs, mental health history, cognitive issues, social support gaps, treatment resistance, and financial or systemic obstacles. Develop and monitor individualized care plans in collaboration with patients, families, and interdisciplinary teams. Evaluate the treatment plan and modify as needed.
Use creative, evidence-based approaches to problem-solving and care coordination. Apply critical thinking to resolve complex patient needs and balance priorities. Coordinates the treatment planning process for patients in the pre-, intra-, and post- care settings, as feasible.
Lead discharge planning for patients with complex barriers preventing discharge from the hospital setting. Collaborate with other members of the treatment team to assure the continuum of care. Develop relationships with key community stakeholders, maintain strong knowledge of and connection with community resources.
Bachelor’s degree in social work required. Master’s degree preferred. Wisconsin Social Worker license required. 3+ years of social work experience in a medical setting required.
Skills in assessing, planning, and managing patient care in an acute care hospital or other health care facility recommended; background in care management, and discharge planning is beneficial; knowledge of available community resources to assure the continuum of care is beneficial. With so many amazing healthcare organizations in this area, why Emplify Health by Bellin? Emplify Health by Bellin offers a proud, local history spanning more than 100 years.
Our personalized patient care model is only the beginning of what you will experience as we foster population health transformation and innovation to serve our communities. You can be part of an exciting dynamic place that offers an employee-first culture, work-life balance, and career advancement & growth opportunities. This culture allows our organization to attract elite talent, like yourself!
Additional perks include: Top-notch
401(k) with matching, paid time off, competitive health insurance, wellness programs to keep you and your family healthy, tuition reimbursement, and more Preventative care focused medical coverage that includes free visits to: Emplify Health by Bellin primary care providers, Urgent Care & Fast Care facilities, physical therapy sessions and any labs required during these visits Access to online continuing education for professional and career development Empowerment to shape your work environment, encouragement to improve processes and create efficiencies, and support when seeking opportunities for growth.
Culture that encourages self-care and provides you with opportunities to be your best self at work and at home Be a member of a passionate workforce, that feels like family and is driven to provide exceptional patient care with a strong focus on community. We inspire your best life by relentlessly caring, learning and innovating. This is our purpose.
Together with our values – belonging, respect, excellence, accountability, teamwork and humility – our pillars set our foundation and our future. Emplify Health by Bellin is an Equal Opportunity Employer.