Job Description

All the benefits and perks you need for you and your family:
Benefits from Day One
Paid Days Off from Day One
Student Loan Repayment Program
Career Development
Whole Person Wellbeing Resources
Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full Time
Shift: Day
Location: AdventHealth DeLand
The community youll be caring for: 701 W PLYMOUTH AVE, Deland, 32720
The role youll contribute:
Works collaboratively across the region with community care nurses, physicians, staff and other health care professionals within the Central Division North Region and PHSO network, to provide care coordination across the health care continuum for patients within the Community Care/Ambulatory Care Coordination program. Serves as an integral member of the health care team who works to ensure members with complex issues or high utilization, navigate through the health care continuum while improving member/family experience and eliminate care gaps through addressing the social determinants of health. Coordinates a wide range of community-based and healthcare support services for members.
The value youll bring to the team:

• Provides Coordination of Care across the care continuum including a manner consistent with safe, efficient and cost-effective resource utilization.
• Assists in the identification of patient populations needing care coordination
• Works with families and patients on needs that may or will affect the patients health, including all dimensions of the social determinants of health such as, transportation issues, financial concerns, end of life planning, etc. in all community settings such as: members home, primary medical home (PCP/FQHC) etc, to eliminate fragmentation, duplication or gaps in health care.
• Identifies potential barriers related to patients home setting and self-care/management needs.
• Maintains an active case load of at risk patients.
• Optimizes member independence through providing education and links to community resources
• Strong knowledge regarding Social Services and Care Management processes in preadmission, emergency department, outpatient/ambulatory services, and post-acute care services.

The expertise and experiences youll need to succeed:
Minimum qualifications:

• Master's Degree
• Clinical Social Worker License (LCSW)
• Driver's License (DL)
• Computer skills and experience with Microsoft Office programs, including Word, Excel, Outlook, and PowerPoint are
• Verbal and written skills necessary to effectively communicate with various members of the health care team, other health facilities, community health related organizations, various external parties and regulatory agencies.
• Ability to use office equipment such as telephone, personal computer, copier, fax machine, etc.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

Skills Required