NewTravel Licensed Clinical Social Worker, Correctional Setting - $1,470 per week Supplemental Health CareTravel Licensed Clinical Social Worker, Correctional Setting - $1,470 per weekLondon, OH$1,340–$1,470 / weekAs recipients of the Best in Staffing Awards for both Client and Talent, Supplemental Health Care is proud to be among only 2% of staffing companies singled out for the distinction based on the real feedback of our employees and the clients we serve. Apply today to get started with this Licensed Clinical Social Worker contract opportunity, or talk to our team about the full range of Social Worker opportunities available.
Licensed Clinical Social Worker HeadwayLicensed Clinical Social WorkerColumbus, OHHeadway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. - Built-in EHR features : Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more.
Licensed Clinical Social Worker - Telehealth HeadwayLicensed Clinical Social Worker - TelehealthColumbus, ALHeadway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. - Built-in EHR features : Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more.
Licensed Clinical Social Worker (LCSW) HeadwayLicensed Clinical Social Worker (LCSW)Columbus, ALHeadway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. - Built-in EHR features : Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more.
Licensed Clinical Social Worker (Virtual) HeadwayLicensed Clinical Social Worker (Virtual)Columbus, ALHeadway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. - Built-in EHR features : Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more.
NewLicensed Clinical Social Worker (Remote) HeadwayLicensed Clinical Social Worker (Remote)Columbus, ALRemoteHeadway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. - Built-in EHR features : Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more.
Travel Medical Social Worker - $1,800 per week in Dublin, OH Windsor Healthcare Recruitment Group, Inc.Travel Medical Social Worker - $1,800 per week in Dublin, OHDublin, OH$1,800Personality Fit: Team player, flexible, works well in a fast paced environment, de-escalation skills. Hiring Profile: Must Have Skills/Experience: Must have an active LSW/LPC, able to pass background, BLS.
NewTravel Nurse RN - ED - Emergency Department - $1,751 per week Fusion Medical Staffing-NursingTravel Nurse RN - ED - Emergency Department - $1,751 per weekColumbus, OHThis role involves assessing patient conditions, implementing urgent care plans, administering life-saving treatments, and collaborating with multidisciplinary healthcare teams to ensure high-quality, efficient, patient-centered care in critical situations. As a member of our team, you'll have the opportunity to make a positive impact on the lives of patients while enjoying competitive pay, comprehensive benefits, and the support of a dedicated clinical team.
NewTravel Nurse RN - ED - Emergency Department - $1,701 per week Fusion Medical Staffing-NursingTravel Nurse RN - ED - Emergency Department - $1,701 per weekColumbus, OHThis role involves assessing patient conditions, implementing urgent care plans, administering life-saving treatments, and collaborating with multidisciplinary healthcare teams to ensure high-quality, efficient, patient-centered care in critical situations. As a member of our team, you'll have the opportunity to make a positive impact on the lives of patients while enjoying competitive pay, comprehensive benefits, and the support of a dedicated clinical team.
NewTravel Nurse RN - Med Surg / Telemetry - $2,044 per week Fusion Medical Staffing-NursingTravel Nurse RN - Med Surg / Telemetry - $2,044 per weekColumbus, OHThis role involves assessing patient health conditions, monitoring cardiac telemetry data, and collaborating with multidisciplinary teams to manage diverse patient needs. Summary: The Med Surg/Tele Registered Nurse delivers comprehensive high-quality, patient-centered care in medical-surgical and telemetry units.
Care Manager (OH BH) AxelonCare Manager (OH BH)Various, OHMust reside in the Northeast Ohio Region (e.g., Medina, Cuyahoga, Lake Lorain, Geauga) and be a Social Worker for medical or behavioral health case management. Provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.
NewTravel Psychology - $72 to $80 per hour in Columbus, OH 22nd Century Healthcare, Inc.Travel Psychology - $72 to $80 per hour in Columbus, OHColumbus, OH$72–$80Collaborate with psychiatrists, physicians, social workers, case managers, and other healthcare professionals. Assignments and facility locations will be communicated in advance to allow for scheduling and planning.
Mental Health Therapist SonderMind CareersMental Health TherapistHilliard, OHKeywords: mental health therapist, telehealth therapy, licensed counselor, AI-powered therapy tools, mental health counseling, clinical notes automation, therapy referrals, insurance credentialing, practice growth support, behavioral health. *Please note that SonderMind does not provide office space; therapists are responsible for securing their own location for in-person sessions, but we can help connect you with other SonderMind therapists looking to share space.
Director of Social Services / LSW Social Worker CommuniCareDirector of Social Services / LSW Social WorkerOhioA family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). You will develop and maintain a good working rapport with other direct caregivers to assure their participation in and support of all programs/services to benefit the residents’ psychosocial wellbeing.
Crisis Intervention Social Worker I/Ii Franklin County, OHCrisis Intervention Social Worker I/IiColumbus, OH$28.38–$33.35 / hourUnder the direction of the Behavioral Health and Addiction Services Division Manager Division Manager, this position serves as a crisis intervention coordinator, responsible for carrying out a broad range of investigative and trauma informed intervention activities to assist individuals in crisis while demonstrating dignity and respect, improving the safety of officers, individuals in crisis, their family members, and other members of the community. Collaborates with Care Coordination and Behavioral Health and Addiction Services to link individuals to services that help prevent homelessness, mental health, and substance abuse issues in the community by addressing the social determinants of health and providing peer support recovery options.
Crisis Intervention Social Worker I/II Franklin County OHCrisis Intervention Social Worker I/IIColumbus, OH$28.38–$33.35 / hourUnder the direction of the Behavioral Health and Addiction Services Division Manager Division Manager, this position serves as a crisis intervention coordinator, responsible for carrying out a broad range of investigative and trauma informed intervention activities to assist individuals in crisis while demonstrating dignity and respect, improving the safety of officers, individuals in crisis, their family members, and other members of the community. Collaborates with Care Coordination and Behavioral Health and Addiction Services to link individuals to services that help prevent homelessness, mental health, and substance abuse issues in the community by addressing the social determinants of health and providing peer support recovery options.
Licensed Counselor or Social Worker Integrated Services for Behavioral HealthLicensed Counselor or Social WorkerLancaster, OH$47,609.67–$71,675.95 / hourMaintains necessary documentation, participates in program evaluation, attends team and program planning meetings, cross-systems training, and acquires knowledge of community resources. It is not to be construed as an exhaustive list of duties performed by the individuals in this role, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision.
Social Worker MSW Gentiva Health Services Inc (Inactive)Social Worker MSWColumbus, OH$66,540–$83,175 / yearAs a key member of the interdisciplinary team, you'll help ensure patients and families receive the guidance and resources they need to navigate the hospice journey with dignity and peace of mind. Compensation may vary within the salary range provided based on several factors including but not limited to a candidate's location, experience, education, skills, licensure, certifications and department equity.
Social Worker- Care Management Central Ohio Primary CareSocial Worker- Care ManagementColumbus, OhioOur patient population is primarily Medicaid-insured and underinsured, often facing barriers such as housing instability, food insecurity, transportation challenges, and untreated mental health conditions. The Care Manager, Social Worker is responsible for identifying and understanding community-based resources and connecting patients with these resources as needed.
LMSW Social Worker / Bereavement Coordinator Hospice LHC Group IncLMSW Social Worker / Bereavement Coordinator HospiceColumbus, OH$26–$32 / hourEducation and Experience License Requirements Bachelor's Degree in social work from a school accredited by the Council on Social Work Education or Bachelor's Degree in psychology, sociology, or other field related to social work and supervised by MSW. Responsibilities The Medical Social Worker for hospice, provides medical social services under the direction of a physician and Interdisciplinary Group to assist in the understanding of significant social and emotional factors related to the patient's health status and in development of coping mechanisms.
Licensed Counselor or Social Worker Integrated Services for Behavioral HealthLicensed Counselor or Social WorkerColumbus, OH$47,609.67–$71,675.95 / hourMaintains necessary documentation, participates in program evaluation, attends team and program planning meetings, cross-systems training, and acquires knowledge of community resources. We serve Southeastern and Central Ohio with a comprehensive array of behavioral health and other services – working with local partners to promote healthy people and strong communities.
Licensed Independent Social Worker Deer OaksLicensed Independent Social WorkerGahanna, OhioDeer Oaks is a nationally recognized leader in geriatric behavioral health, partnering with thousands of facilities across the country to deliver compassionate, evidence-based care to older adults and individuals with chronic medical conditions. Focused exclusively on behavioral health in long-term care since 1992, Deer Oaks proudly serves thousands of skilled nursing and assisted living facilities nationwide.
Licensed Social Worker, Therapist or Counselor UnitedHealth Group IncLicensed Social Worker, Therapist or CounselorColumbus, OH$52,000–$78,100 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Annual total cash compensation for this role assumes full time employment and generally follows the range above, includes earnings from hourly pay ($22.00/hr) and incentive pay and is based on several factors including but not limited to local labor markets and may increase over time based on productivity and performance in the role.
Licensed Clinical Social Worker – Correctional Setting Supplemental Health CareLicensed Clinical Social Worker – Correctional SettingOrient, OHFull timeApply today to get started with this Licensed Clinical Social Worker contract opportunity, or talk to our team about the full range of Social Worker opportunities available. With more than 40 years of experience in healthcare staffing, Supplemental Health Care offers reliable support, competitive pay, and great benefits every step of the way.
Behavioral Health Licensed Clinical Social Worker Supplemental Health CareBehavioral Health Licensed Clinical Social WorkerColumbus, OHFull timeWhether you're looking to travel or stay local, we're committed to helping Psychiatric Licensed Clinical Social Workers find the right fit with top healthcare facilities across the country. Apply today to get started with this Psychiatric Licensed Clinical Social Worker contract opportunity, or talk to our team about the full range of Licensed Clinical Social Worker opportunities available.
Mental Health Clinic Social Worker Supplemental Health CareMental Health Clinic Social WorkerColumbus, OHPart timeWhether you're looking to travel or stay local, we're committed to helping Social Worker Social Workers find the right fit with top healthcare facilities across the country. With more than 40 years of experience in healthcare staffing, Supplemental Health Care offers reliable support, competitive pay, and great benefits every step of the way.
Medical Social Worker MSW Home Health PRN Elara CaringMedical Social Worker MSW Home Health PRNWorthington, OHAs a Medical Social Worker (MSW), youll contribute to our success in the following ways: Ensures that all activities are performed aligned with the vision of Elara Carings board of directors, executive team, and the leadership of the Home Health team. Assesses patients to identify the psychosocial, financial, and environmental needs of patients as evidenced by documentation, clinical records, case conferences, team report, call-in logs, and on-site evaluations.
NewDialysis Social Worker - PT U.S. Renal Care IncDialysis Social Worker - PTDelaware, OHThe Licensed Master Social Worker provides social services to patients and their families in a timely and efficient manner in order to promote maximum social functioning and psychological adjustment to dialysis and rehabilitation of the patient. Identify social agencies and other resources as appropriate to the needs of the patients, including but not limited to financial/funding sources.
Social Worker (MSW) DaVita IncSocial Worker (MSW)Columbus, OHOur social workers typically have a caseload of around 115-125 patients however that's spread between clinics so it's not that a social work sees that many patients every day. DaVita provides the opportunities for support for you and your family with family resources, EAP counseling sessions, access to Headspace, backup child, elder care, maternity/paternity leave, pet insurance, and so much more!
Clinical Social Worker Health Care Facility Surveyor Impact Recruiting SolutionsClinical Social Worker Health Care Facility SurveyorGrove City, Ohio$72,000–$80,000Impact Recruiting Solutions is currently seeking a Clinical Social Worker Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide. Must have at least two (2) years of recent experience working as a surveyor accrediting or certifying facilities that serve the residents of long-term care facilities.
Sr. Clinical Consultant Social Worker (MSW/LISW) OhioHealth CorpSr. Clinical Consultant Social Worker (MSW/LISW)Columbus, OHThis position is responsible for providing services to patients, families and significant others including, as appropriate, completion of biopsychosocial assessments, psychiatric diagnoses, formulation of treatment plans and treatment interventions, therapy sessions (individual, couple, families or group), implementation of treatment plans and discharge planning in order to support and/or enhance biopsychosocial functioning. Minimum Qualifications: Master''s Degree: Social Work (Required)DL-HC - Driver''s License only if in a Home Care department - Department of Motor Vehicles, LISW - Licensed Independent Social Worker - Social Work Certification and Licensure Board, LPCC - Licensed Professional Clinical Counselors - American Counseling Association.
Integrated Social Worker LOWER LIGHTS CHRISTIAN HEALTH CENTER INCIntegrated Social WorkerColumbus, OHThe ISW partners closely with providers, community health workers, psychiatry providers, counselors, practice managers, and medical assistants to assist in the identification and triage of acute mental and behavioral health needs which arise within the primary care setting. Is a member of the multidisciplinary, primary care team, and communicates and interacts with all levels of staff, primary care providers and patients with professionalism and respect.
Clinical Medical Social Worker EX - School Health Services Nationwide Children's HospitalClinical Medical Social Worker EX - School Health ServicesColumbus, OhioPhysical Requirements: OCCASIONALLY: Biohazard waste, Blood and/or Bodily Fluids, Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 11-20 lbs, Lifting / Carrying: 21-40 lbs, Loud Noises, Patient Equipment, Pushing / Pulling: 0-25 lbs, Pushing / Pulling: 100 lbs or greater with assistance, Pushing / Pulling: 26-40 lbs, Pushing / Pulling: 41-60 lbs, Pushing / Pulling: 61-100 lbs, Working Outdoors. FREQUENTLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Hand use: grasping, gripping, turning, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Repetitive hand/arm use, Sitting, Squat/kneel, Standing, Walking.
NewSocial Service Worker III (Recent Wage Increase) Delaware County CouncilSocial Service Worker III (Recent Wage Increase)Delaware, OH$24.67–$35.78 / hourDelaware County offers a complete benefits package to full-time employees including: health care, Flexible Spending Account (FSA), dental care, life insurance, pension, holidays, vacation, sick leave, and deferred compensation plans. Performs typing, word processing, and related computer operations; Works overtime and outside of typical work schedule/business hours as required; and.
Social Worker Ohio Department of EducationSocial WorkerPickerington, OHOhio Department of Education and Workforce Pupil Services license as a School Social Worker (preferred) and/or registration. Social Work license issued by the Ohio Counselor, Social Worker, Marriage and Family Therapist Board (LSW or LISW).
Clinical Consultant Social Worker OhioHealth CorpClinical Consultant Social WorkerOHThis position is responsible for providing services to patients, families and significant others including, as appropriate, completion of biopsychosocial assessments, psychiatric diagnoses, formulation of treatment plans and treatment interventions, therapy sessions (individual, couple, families or group), implementation of treatment plans and discharge planning in order to support and/or enhance biopsychosocial functioning. Through individual, family, or group modalities, employs clinical intervention skills including, but not limited to, treatment planning; continuum of care planning (including discharge planning); supportive counseling; crisis intervention; specialized problem oriented planning and intervention; and educational counseling.
Clinical Consultant Social Worker (LSW/MSW) Work at Home OhioHealth CorpClinical Consultant Social Worker (LSW/MSW) Work at HomeOHThrough individual, family, or group modalities, employs clinical intervention skills including, but not limited to, treatment planning; continuum of care planning (including discharge planning); supportive counseling; crisis intervention; specialized problem oriented planning and intervention; and educational counseling. Minimum Qualifications: Master''s Degree (Required)DL-HC - Driver''s License only if in a Home Care department - Department of Motor Vehicles, LSW - Licensed Social Worker - Social Work Certification and Licensure Board.
Clinical Consultant Social Worker (MSW/LSW) OhioHealth CorpClinical Consultant Social Worker (MSW/LSW)Columbus, OHThrough individual, family, or group modalities, employs clinical intervention skills including, but not limited to, treatment planning; continuum of care planning (including discharge planning); supportive counseling; crisis intervention; specialized problem oriented planning and intervention; and educational counseling. Minimum Qualifications: Master''s Degree: Social Work (Required)DL-HC - Driver''s License only if in a Home Care department - Department of Motor Vehicles, LSW - Licensed Social Worker - Social Work Certification and Licensure Board.
Social Worker MSW Heartland HospiceSocial Worker MSWColumbus, Ohio$66,540–$83,175 / yearFull timeOur nationwide reach is powered by a family of trusted brands that include: Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon. Our place is by the side of those who need us – from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.
Social Worker , Case Management Trinity HealthSocial Worker , Case ManagementDublin, OHPosition Purpose: The Emergency Department Social Worker intervenes with patients who have complex psychosocial needs, require assistance with eligibility determination for social programs and funding sources and qualify for community assistance from a variety of special funds and agencies. Our approach empowers the patient and family to actively participate in the care discussion and decision-making process as care plans are adjusted, barriers addressed, post-acute resources aligned, and concerns resolved.
NewMedical Social Worker Alternate Solutions Health NetworkMedical Social WorkerColumbus, OhioWe've launched a new guaranteed base hourly rate plus a generous uncapped bonus structure which is designed to reward excellence, encourage growth, and recognize the incredible impact our Clinicians make every day. Interacting with patients' families while caring for your patients and experiencing the rewarding privilege to be part of every step of their recovery journey.
Licensed Social Worker, Therapist Or Counselor UnitedHealth Group Inc.Licensed Social Worker, Therapist Or CounselorColumbus, OH$52,000–$78,100 / yearAnnual total cash compensation for this role assumes full time employment and generally follows the range above, includes earnings from hourly pay ($22.00/hr) and incentive pay and is based on several factors including but not limited to local labor markets and may increase over time based on productivity and performance in the role. Affirmations Psychological Services, part of the Optum family of businesses, is seeking a Pre-Licensed Social Worker/ Therapist/ Counselor to join our team in Columbus, Ohio.
Clinical Medical Social Worker MSW NE- CSCC Social Work Nationwide Children's HospitalClinical Medical Social Worker MSW NE- CSCC Social WorkColumbus, OHPhysical Requirements: OCCASIONALLY: Biohazard waste, Blood and/or Bodily Fluids, Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 11-20 lbs, Lifting / Carrying: 21-40 lbs, Loud Noises, Patient Equipment, Pushing / Pulling: 0-25 lbs, Pushing / Pulling: 100 lbs or greater with assistance, Pushing / Pulling: 26-40 lbs, Pushing / Pulling: 41-60 lbs, Pushing / Pulling: 61-100 lbs, Working Outdoors. FREQUENTLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Hand use: grasping, gripping, turning, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Repetitive hand/arm use, Sitting, Squat/kneel, Standing, Walking.
FT Palliative Social Worker National Church ResidencesFT Palliative Social WorkerOHExperience: Preferred minimum of two (2) years in varied multi-disciplinary settings in the health care field with experience working with clients and family counseling; however, requires one year of social work experience in a health care setting. PURPOSE According to prescribed policies and procedures of the organization, including all applicable federal, state, and accreditation regulations, and under the general supervision of the Director of Clinical Management, is responsible to provide clients and families psychosocial care regarding emotional, social, and economic needs.
Social Worker I Ohio Hospital for PsychiatrySocial Worker IColumbus, OhioPer diemEligible for state licensure as one of the following: Licensed Social Worker (LSW), Licensed Associate Counselor (LAC), Certified Addictions Counselor (CAC), Registered Addiction Counselor (RAC), as required by the state in which the facility is operating. Conduct social history assessment of the patient through observation and patient/family interview, obtaining information on the patient’s needs, skills, interests and limitations for the development and implementation of the treatment plan.
Clinical Medical Social Worker - Healthy Weight and Nutrition/Bariatrics Nationwide Children's HospitalClinical Medical Social Worker - Healthy Weight and Nutrition/BariatricsColumbus, OhioPhysical Requirements: OCCASIONALLY: Biohazard waste, Blood and/or Bodily Fluids, Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 11-20 lbs, Lifting / Carrying: 21-40 lbs, Loud Noises, Patient Equipment, Pushing / Pulling: 0-25 lbs, Pushing / Pulling: 100 lbs or greater with assistance, Pushing / Pulling: 26-40 lbs, Pushing / Pulling: 41-60 lbs, Pushing / Pulling: 61-100 lbs, Working Outdoors. FREQUENTLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Hand use: grasping, gripping, turning, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Repetitive hand/arm use, Sitting, Squat/kneel, Standing, Walking.
NewSocial Worker Macpower Digital Assets Edge Private LimitedSocial WorkerWesterville, OHCommunicates with and performs duties following the philosophy of MercyOne North Iowa Medical Center and the Sisters of Mercy reflecting the organization's Mission, Values, and Impact our key results. Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, arranging transportation, etc., as necessary, coordinating activities with other departments as necessary.
NewMedical Social Worker, Home Health Trinity HealthMedical Social Worker, Home HealthColumbus, OHESSENTIAL FUNCTIONS: Assessment/Evaluation Obtains social history information and identifies patient needs by interviewing the patient/family, reviewing the medical record, conferring with physicians and appropriate medical center staff and contacting other information sources as necessary and appropriate. Shift: Description: The Medical Social Worker is responsible for the provision of consultation and service to homebound individuals in the need of assistance with the solution of complex social and emotional problems, which impede management of medical regimen.
Clinical Consultant Social Worker (Casual/Days M-F) OhioHealth CorpClinical Consultant Social Worker (Casual/Days M-F)Dublin, OHThis position is responsible for providing services to patients, families and significant others including, as appropriate, completion of biopsychosocial assessments, psychiatric diagnoses, formulation of treatment plans and treatment interventions, therapy sessions (individual, couple, families or group), implementation of treatment plans and discharge planning in order to support and/or enhance biopsychosocial functioning. Through individual, family, or group Modalities, employs clinical intervention skills including, but not limited to, treatment planning; continuum of care planning including discharge planning g; supportive counseling; crisis intervention; specialized problem oriented planning and intervention; and educational counseling.
Social Worker , Case Management Trinity Health CorporationSocial Worker , Case ManagementDublin, OHPosition Purpose: The Emergency Department Social Worker intervenes with patients who have complex psychosocial needs, require assistance with eligibility determination for social programs and funding sources and qualify for community assistance from a variety of special funds and agencies. Our approach empowers the patient and family to actively participate in the care discussion and decision-making process as care plans are adjusted, barriers addressed, post-acute resources aligned, and concerns resolved.