Vumc
MSW Social Worker-1
Clarksville, TN
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hirly's read of this role
- Seniority
- Mid level
- Country
- US
- Work mode
- On-site / unstated
- First seen by hirly
- 1 Oct 2026
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the posting
Discover Vanderbilt Health : With eight hospitals and over 180 clinics, we are the region’s largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South, living out our mission of moving medicine forward through preeminent programs in patient care, education and research. Here you’ll find a spirit of collaboration and a supportive community where your expertise is valued, your knowledge expanded and your uniqueness celebrated. We are committed to fostering an environment where talented, compassionate people are united in bringing the most advanced care to our neighbors throughout the region.
Organization:
VCH Case Management
Job Summary:
The Social Worker will evaluate the psychosocial needs of patients and family support systems and will coordinate appropriate discharge plans for identified patient populations. The Social Worker acts as a liaison between the facility and resources external to the organization. He/she will facilitate implementing timely discharge plans and facilitate follow-up to anticipated post-acute interventions identified in the plan of care. The Social Worker will provide crisis intervention and support. The Social Worker will assist the Resource Manager in facilitating patient movement across the continuum of care and will identify and track barriers to patient throughput.
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KEY RESPONSIBILITIES
- Performs a comprehensive assessment of psychosocial needs of assigned patients
- Assesses patients discharge needs and facilitates the provision of services necessary to meet identified needs
- Evaluates suspected abuse and neglect referrals and makes official reports
- Develops an individual plan of care for recurring patients to include education related to accessing healthcare services at the appropriate level of care
- Provides education to the under-resources patient/family of potential and available resources
- In collaboration with the interdisciplinary team, develops, implements, evaluates, revises as needed, a discharge plan to include identifies psychosocial an discharge needs
- Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to all members of the health care team
- Participates with the interdisciplinary team to ensure psychosocial and discharge needs are addressed
- Acts as a liaison through effective and professional communications between and with physicians, patient/family, hospital staff, and outside agencies
- Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives
- Makes appropriate referrals, after collaboration with the Case Manager, to third party payer disease and case management programs for recurring patients and patients with chronic disease states
- Facilitates patient throughput with an ongoing focus on quality outcomes and an efficient transition between levels of care
- Tracks and trends barriers to care, makes recommendations and develops action plans to improve processes and systems
- Provides psychosocial support to patients and families through crises intervention
- Actively seeks ways to control costs without compromising patient safety, quality of care or the services delivered
- Acts as an advocate for identified needs and makes appropriate referrals
- Acts as a liaison between the facility and community resources to enhance community outreach coordination
- Tracks and trends variances barriers related to access to care
- Adheres to established policy and procedure and standard of care
TECHNICAL CAPABILITIES
- Risk Management (Novice): Possesses sufficient fundamental proficiency to successfully demonstrate risk management of moderate difficulty. Capable of conducting risk analysis as part of a task to address problems including determining risk factors, probability, impact, early detection and prevention. Able to prepare simple contingency plans and alternatives.
- Crisis Intervention (Novice): Possesses sufficient fundamental proficiency to successfully demonstrate crisis intervention in practical applications of moderate difficulty.
- Patient Evaluation (Novice): Possesses sufficient fundamental proficiency to successfully demonstrate the ability to conduct a patient evaluation in practical applications of moderate difficulty. Capable of effectively assessing the relative merits of alternative products or services.
- Patient Assessment (Novice): Possesses sufficient fundamental proficiency to successfully demonstrate patient assessments in practical applications of moderate difficulty.
- Clinical Counseling (Novice): Possesses sufficient fundamental proficiency to successfully demonstrate clinical counseling in practical applications of moderate difficulty.
Allied health is among the fastest growing occupations in healthcare today. This area can be defined as credentialed professionals who perform supportive, diagnostic, and therapeutic health care services to promote health and prevent disease in a variety of settings.
These areas are crucial to Vanderbilt Health’s reputation for excellence in these areas that has made us a major center for patient referrals from throughout the Mid-South.
Each year, people throughout Tennessee and the southeast choose Vanderbilt Health for their health care because of our leadership in medical science and our dedication to treating patients with dignity and compassion.
Core Accountabilities:
Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members.
Core Capabilities :
Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas.- Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.- Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services:- Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.- Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.- Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.- Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.- Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.- Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation:- Generates New Ideas: Proactively identifies new ideas/o
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