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Social Worker Care Coordination

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Job ID: 209431
Category: Social Work
Work Type: FT
Location: Plainsboro, NJ, United States
Work Schedule: FT

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Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?


  • Perform activities to meet patient’s and families’ needs in a manner that optimizes the discharge planning process. Facilitates post-hospital continuity of care. Provides counseling, education and support interventions that enhance patient’s and families’ ability to cope with physical, emotional and environmental problems.


  • Assesses patient’s and family’s psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope. Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability; advocates for patient and family empowerment and independence to make autonomous health care decisions; accesses and mobilizes family/community resources to meet identified needs. Provides intervention in child abuse/neglect, domestic violence, guardianship (temporary/ permanent), foster care, adoption, mental health placement, advance directives, adult/elderly abuse, child protection and sexual assault. Serves as a resource person and provides counseling and intervention related to treatment decisions and end-of-life issues. Participates in discharge planning activities for complex patients, in order to ensure a timely discharge and to provide appropriate linkage with post-discharge care providers. Intervenes with families exhibiting complex family dynamics that impact directly on patient care and discharge. Communicates with members of interdisciplinary team regarding the discharge planning status of assigned caseload. Educates patient/family and physician regarding post-acute options and addresses issues of choice. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff. Documents social work interventions and relevant discharge planning information in the medical record according to Department standards.


  • LCSW or LSW (Required)

Education or Equivalent Experience:

  • Masters of Social Work from graduate school of social work approved by the Council on Social Work Education required

Related Work Experience

  • Preferred 1 year hospital social work or related health care experience. 

    We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

    Live Your Life's Work

    We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

       Current UPHS employees must apply HERE
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