Gundersen Health System·Onalaska, Wisconsin
Provide comprehensive case management, care coordination, and resource navigation for patients with complex medical and social needs. Act as a consultant and leader within the healthcare system to improve patient outcomes through a whole-person approach.
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Scheduled Weekly Hours: 40 Complex Care Services is an interdisciplinary, PCP-based care model designed for patients 18 years and older with complex medical, behavioral, and social needs.
The social worker partners with clinicians, RN care coordinators, pharmacists, behavioral health professionals, and community organizations to provide relationship-based support, comprehensive case management, and care coordination across healthcare and community settings.
Through resource navigation, advocacy, and addressing barriers to health, the social worker helps improve patient outcomes through a whole-person approach to care.
This role requires strong collaboration, expertise in supporting high-risk populations, and a commitment to innovative care delivery.
Beginning in January 2027, team members will practice within the Exam Room of the Future, a next-generation care environment that leverages advanced technology, innovative equipment, and purpose-built collaborative spaces to support whole-person care, improve team efficiency, and create a more personalized and engaging experience for patients and care teams alike.
Emplify Health by Gundersen Health System is now hiring a full-time Ambulatory Care Social Worker in Onalaska, WI!
Social Workers provide assessment, planning, consulting, education and referral services to Emplify Health patients and family members as well as act as consultants and leaders in comprehensive care throughout the system, while supporting organizational strategies and goals.
What you will work: 1.0 FTE = 40 hours every 2 weeks Monday – Friday, 8am - 5pm No weekends or holidays Location: This position is located in Onalaska What you will do: Provide a variety of services to our patients including care coordination, care navigation, resource connections, supportive listening, ACP completion, discharge planning and long-term care planning Help patients and families understand the illness and treatment options, as well as consequences of various treatments or treatment refusal.
Help patients and families adjust to hospital admission; possible role changes; emotional/social responses to illness and treatment.
Act as consultants and leaders in comprehensive care throughout the system, while supporting organizational strategies and goals.
What you will get: Starting wage of $25.95/hour + more for relatable experience Department with a strong teamwork model Generous compensation and benefit package!
Growth opportunities and access to Gundersen's Career Development Center to help you navigate your career What you will need: Bachelor’s degree in Social Work or in a related field WI Social Worker license must be active prior to start date It is desired candidates have 1 year work experience in social services in a hospital, medical clinic, county social service agency or nursing home.
About Emplify Health by Gundersen: Emplify Health, a partnership of Bellin Health and Gundersen Health System, is a leading not-for-profit, patient-centered healthcare network based in Green Bay and La Crosse, Wisconsin.
With 11 hospitals and over 100 clinics, we serve 67 cities across Wisconsin, Iowa, Minnesota, and Michigan's Upper Peninsula.
Join us in making a meaningful difference in the lives of our patients and communities.
Equal Opportunity Employer If you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267.
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.
Equal Opportunity Employer
Requires a Bachelor's degree in Social Work or a related field and an active Wisconsin Social Worker license. One year of experience in social services within a medical or agency setting is desired.
Market context
Behavioral-health roles in Wisconsin are typically in steady demand because employers need licensed professionals who can support patients across healthcare and social-service settings. This role is competitive because it requires a current Social Worker license, at least two years of experience, and a Bachelor’s in Social Work, with a Master’s preferred; the listed benefits include health, dental, vision, PTO, and 401(k) matching. Review the AI-summarized requirements and benefits carefully on this platform to save time, then confirm your licensure and experience match before applying.
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