Social Worker Case Manager 1 - Transplant

Inova Health System
Falls Church, VA

Inova Fairfax Transplant Team is looking for a dedicated Experienced Social Worker Case Manager to join the Case Management Team. This role will be Full-Time, Monday-Friday 8:00am - 4:30pm. No evenings & no weekends.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Inova Fairfax Hospital is proud to announce that the American Nurses Credentialing Center (ANCC) awarded Magnet designation, the most prestigious accolade for nursing excellence, to our hospital in December 2020. Currently, only 8.5% of hospitals in the nation hold Magnet designation and Inova Fairfax Hospital is proud to be part of this select group. The new Magnet designation is in addition to several other prestigious recognitions which include: a five star rating from the Centers for Medicare and Medicaid Services (CMS), being named by IBM Watson Health as one the nation's highest performing hospitals, and among the top 10 Major Teaching Hospitals, an A for Patient Safety by The Leapfrog Group, the #1 hospital in the DC metro area by U.S. News & World Reports, and being nationally ranked in gynecologic care.

Featured Benefits:

  • Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
  • Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
  • Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
  • Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
  • Work/Life Balance: offering paid time off, paid parental leave, and flexible work schedules

Social Worker Case Manager 1 Job Responsibilities:

  • Participates in the assessment of patients' biopsychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary care team members. Communicates routinely with patients, families, interdisciplinary care team members and other appropriate parties with regard to the status of patients' care plans. progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary.
  • Ensures that all options available to support a successful transition and elements critical to patients' care plans have been communicated to patients/families and members of the healthcare team and are documented as necessary to ensure continuity of care. Refers cases and issues appropriately to resolve barriers to care progression. Acts as an advocate for patients to resolve barriers to care progression.
  • On the basis of preliminary risk screenings, assesses the psychosocial risk factors of patients/families through the evaluation of prior functional levels, appropriateness/adequacy of support systems, reactions to illnesses and the ability to cope.
  • Intervenes with patients/families regarding emotional, social and financial consequences of illness and/or disability.
  • Serves as a resource person and provides counseling and interventions related to treatment and end of life decisions. Advocates for patient/family empowerment and independence to make autonomous healthcare decisions and access needed healthcare services.
  • Provides discharge planning and continuity of care for assigned patients in the acute and post-acute settings
  • Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
  • Collaborates with the interdisciplinary care team, patients and families in the assessment/coordination of discharge planning needs, delivery of post-discharge planning needs, delivery of post-discharge services and transition of patients from the hospital to the discharge setting as well as ongoing care in the community.

Minimum Requirements:

  • Education: Master's Degree in Social Work
  • Experience : Requires a minimum of 1 year of experience in clinical care or clinical case management.
  • Certification: Basic Life Support (BLS) for Healthcare Provider certification from the American Heart Association required upon start.

Preferred Qualifications:

  • One (1) year of previous inpatient case management experience and experience conducting psychosocial evaluation/counseling within the healthcare setting is strongly preferred.
Posted 2025-08-10

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