Hudson Regional Hospital·Bayonne, New Jersey
Provide comprehensive psychosocial support, crisis intervention, and complex discharge planning for patients and their families. Collaborate with interdisciplinary teams to ensure smooth transitions of care and connect patients with essential community resources.
The Medical Social Worker plays a vital role in patient care by providing comprehensive psychosocial support, crisis intervention, and complex discharge planning. You will work closely with an interdisciplinary team to ensure smooth transitions of care, advocate for patient needs, and connect families with essential community resources.
Patient Assessment & Support
Interview patients, families, and community support services to assess psychological, social, environmental, and financial status.
Identify "high-risk" patients requiring complex social work services and advanced discharge planning.
Engage patients and families in necessary decision-making during hospitalization, including treatment and discharge planning.
Provide crisis intervention to help patients and families cope with end-of-life issues, catastrophic events, and adjustments to new or chronic illnesses.
Discharge Planning & Care Coordination
Facilitate continuous discharge planning to ensure continuity of care and transition to the least restrictive setting.
Participate actively in Interdisciplinary Discharge Planning Rounds to assess needs, identify barriers, and communicate ongoing interventions.
Educate patients and families regarding discharge plans, care needs, and the availability/eligibility of beneficial programs and services.
Creatively negotiate, coordinate, and advocate for community-based services (e.g., DYFS, APS, Office of Public Guardian, DDD) to ensure appropriate, age-specific continuation of care.
Keep patients and families informed of progress, helping them anticipate and understand any delays or changes in the care plan.
Documentation & Quality Improvement
Accurately document all assessments, reassessments, and interventions in the Medical Record to enhance multidisciplinary communication and meet regulatory/reimbursement standards.
Maintain appropriate case folders, resource files, and statistical reports to facilitate monitoring and evaluation; assist in initiating corrective actions when deficiencies are identified.
Monitor discharge planning delays to identify and report trends, contributing to ongoing performance improvement initiatives.
Attend relevant Social Work conferences and workshops to maintain required CEUs and license-specific credentials.
Day shift Monday-Friday Weekends as needed 40 hours
Market context
Behavioral health positions in New Jersey often draw steady demand from providers serving children, families, and community-based programs. These roles can be competitive because employers commonly look for a master’s degree, a valid clinical license, bilingual communication skills, and child welfare experience. Review the AI-summarized requirements and benefits here to save time, and tailor your application to highlight licensure, language ability, and direct child welfare exposure.
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