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Location: Plymouth, MI | Onsite
Schedule: Full-Time | Hourly
Position Summary
Responsible for coordinating safe, effective discharge planning for residents in a Skilled Nursing Facility. Works collaboratively with the interdisciplinary team to address psychosocial needs and ensure smooth transitions of care.
Key Responsibilities
Coordinate discharge planning from admission through discharge
Complete psychosocial and behavioral assessments
Develop and implement individualized discharge plans
Collaborate with nursing, therapy, physicians, and case management
Educate residents and families on post-discharge options and resources
Address barriers to discharge, including social, emotional, and mental health needs
Ensure compliance with state, federal, and Medicare discharge regulations
Maintain accurate documentation in the medical record
Qualifications
BSW/MSW or Psychology degree required
Michigan licensure or eligibility required
SNF, hospital, or post-acute experience preferred
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