Medical Social Worker (Full Time, Day)

NorthBay Health is seeking a Medical Social Worker to join our team in Fairfield, CA, supporting our inpatient hospital units and broader care coordination efforts. This role is essential in improving patient outcomes through clinical intervention, education, and continuity of care across both inpatient and outpatient settings. This role plays a key part in identifying patients at risk for readmission and ensuring seamless transitions across the continuum of care.

The Medical Social Worker will primarily support inpatient hospital units, partnering closely with interdisciplinary teams to assess patient needs and implement interventions that enhance recovery and reduce readmissions. In collaboration with Population Health, this role will also extend into outpatient care by supporting high-utilizer patients through coordinated, team-based follow-up.

Responsibilities

Conduct daily reviews of inpatient unit census to identify patients in need of social work intervention. Perform psychosocial assessments and develop care plans tailored to individual patient needs. Provide clinical intervention, counseling, and patient/family education to support optimal health outcomes. Identify barriers to discharge and coordinate appropriate resources and services. Collaborate with physicians, nurses, case managers, and interdisciplinary teams to ensure continuity of care. Partner with Population Health teams to support high-utilizer patients in outpatient settings. Facilitate smooth transitions from inpatient to outpatient care, reducing avoidable readmissions. Connect patients and families with community resources, including behavioral health, housing, transportation, and financial assistance. Maintain accurate, timely documentation in compliance with regulatory and organizational standards.

Interpersonal Skills and Values Demonstrates NorthBay Health’s True North Values

Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care. Why NorthBay Health NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics. We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions. We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities. NorthBay Health Benefits Options NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance. Compensation Structure NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements. Remote Work Disclosure NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs. Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States. Notice to Recruitment Agencies NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings. More Information Visit NorthBay Health Careers for recruitment FAQs and additional information.