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.
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
Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity -- of culture, thinking, learning and leading -- is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.
Vanderbilt Harton Hospital:
Our 135-bed facility is accredited by The Joint Commission and features an accredited Chest Pain Center.
Acquired by Vanderbilt Health in 2021, the hospital has served Tullahoma, Coffee County, and surrounding counties for more than 50 years. With more than 100 doctors and 500 hospital staff, Vanderbilt Tullahoma-Harton Hospital delivers personalized, high-quality health care close to home, offering a comprehensive range of services in a modern, patient-friendly environment
Our goal is to create an exceptional experience for our patients and their families: keeping them safe, delivering evidence-based medicine, and treating them with kindness and respect.
View how Vanderbilt Health employees celebrate the difference they make every day:
VUMC Recent Accomplishments
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
US News & World Report: #1 Adult Hospital in Tennessee and metropolitan Nashville, named to the Best Hospitals Honor Roll of the top 20 adult hospitals, 10 nationally ranked adult specialty programs, with 3 specialties rated in the top 10 nationally, Monroe Carell Jr. Children's Hospital at Vanderbilt named as one of the Best Children's Hospital in the nation, with 10 out of 10 pediatric specialties nationally ranked.
Healthcare's Most Wired: Among the nation's 100 "most-wired" hospitals and health systems for its efforts in innovative medical technology.
Becker's Hospital Review: named as one of the "100 Great Hospitals in America", in the roster of 100 Hospitals and Health Systems with Great Oncology Programs and to its list of the 100 Hospitals with Great Heart Programs.
The Leapfrog Group: One of only 10 children's hospitals in the to be named at Leapfrog Top Hospital.
American Association for the Advancement of Science: The School of Medicine has 112 elected fellows
Magnet Recognition Program: Received our third consecutive Magnet designations.
National Academy of Medicine: 22 members, elected by their peers in recognition of outstanding achievement
Human Rights Campaign Healthcare Equality Index: 6 th year in a row that Vanderbilt University Medical Center was a Leader in LGBTQ Healthcare Equality.
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period. Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As t...he largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.