NJ - Elizabeth (07202)
The Transitional Care program provide services to patients with chronic diseases such as heart Failure, Chronic Obstructive Pulmonary disease, Diabetes, uncontrolled Hypertension, whose medical and/or psychosocial problems require moderate or high-complexity medical decision making during transitions in care from an inpatient hospital setting (including acute hospital, rehabilitation hospital, long-term acute care hospital), to the patient’s community setting (home, and or assisted living). The Team follow up with patients 18 years old and over within 24 to 72 hours after discharged home.
Master's degree in Social Work (M.S.W.) from an accredited School of Social Work; New Jersey State Social Work Licensure (L.S.W. or L.C.S.W.) Hospital experience strongly preferred; good communication and writing skills; ability to work in a multidisciplinary team.