Discharge Planning Associate

About the Role

Discharge Planning Associates/Social Workers are an important part of a multi-disciplinary treatment team contributing to the assessment, treatment, and disposition planning of all patients. Discharge Planning Associates will support the Discharge Plan Managers and treatment teams. This position offers a sign-on bonus of up to $6,000!

Key Responsibilities

Assessment & Care Planning

• Assess clinical, psychosocial, and social needs to guide individualized care plans.
• Evaluate health literacy, understanding, and engagement in goals of care.
• Identify self-care capacity, support systems, discharge barriers, and post-acute needs.
• Reassess plans regularly to ensure safe, appropriate transitions.

Discharge Coordination

• Lead interdisciplinary planning to ensure safe, timely discharges.
• Coordinate post-hospital services and maintain knowledge of community resources.
• Integrate patient goals, team input, and available resources into transition plans.
• Update plans based on clinical recommendations, test results, and care milestones.

Communication & Collaboration

• Communicate clearly with patients, caregivers, and the care team.
• Serve as liaison between hospital teams, post-acute providers, and physicians.
• Collaborate across disciplines to create individualized care and discharge plans.

Advocacy & Ethical Practice

• Advocate for patient rights, safety, and access to needed services.
• Uphold organizational values, ethical standards, and regulatory compliance.

Quality & Resource Management

• Balance cost, safety, quality, and patient satisfaction in care decisions.
• Use technology to enhance coordination and outcomes.
• Document care accurately in the medical record.

Professional Support

• Provide orientation, guidance, and mentoring to staff.

Requirements & Tech Stack

Education

• Diploma or Associate's Degree in Nursing.
• OR Bachelor's degree in social work or another health or human services field that promotes the physical, psychosocial, and/or vocational well-being of those being served required.
• A copy of your official Bachelor’s Degree level transcripts must be attached for consideration.

Licensure, Certifications, and Clearances

• Registered Nurses employed in this position are required to maintain active RN license.
• Comprehensive Crisis Management (CCMC)
• Act 31 Child Abuse Reporting with renewal
• Act 33 with renewal
• Act 34 with renewal
• Act 73 FBI Clearance with renewal

Qualifications

Experience

• No experience in discharge planning/care coordination required.
• Clinical/patient-facing experience preferred.

Knowledge and Skills

• Excellent communication skills required.
• Must be skilled in planning/organization, follow up/control, problem solving, self-development orientation, organizational behaviors/competencies.
• Must possess the ability to apply principles of logic and critical thinking to a wide range of problems and to deal with a variety of abstract and concrete variables.
• Comfortable working both independently and as a team member.
• Proficient computer skills.