Orlando Health
Care Coordinator, Social Worker I - Bayfront Hospital, St. Petersburg, Florida
Orlando Health, Orlando, Florida, us, 32885
Care Coordinator, Social Worker I - Bayfront Hospital, St. Petersburg, Florida
Join to apply for the
Care Coordinator, Social Worker I - Bayfront Hospital, St. Petersburg, Florida
role at
Orlando Health Position Overview Site:
Orlando Health Bayfront Hospital Location:
St. Petersburg, Florida Department:
Case Management Position:
Care Coordinator, Social Worker I About Orlando Health Bayfront Hospital Orlando Health Bayfront Hospital is a comprehensive tertiary care facility that has served St. Petersburg and the surrounding communities for more than 100 years. A teaching medical center, the 480-bed hospital’s areas of expertise include heart and vascular, digestive health, orthopedics, surgical services, robotic surgery, rehabilitation, neurosciences, maternity care, emergency services and trauma care. The hospital’s Level II Trauma Center is the only adult trauma center in Pinellas County. In partnership with Johns Hopkins All Children’s Hospital, it is one of Florida’s 13 state-certified Level III Regional Perinatal Intensive Care Centers. The hospital has received recognitions such as the Today Top Workplaces award for 2025 and an “A” Hospital Safety Grade for Spring 2025 from The Leapfrog Group. Orlando Health Bayfront Hospital is part of the Orlando Health system of care, which includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities across Florida and beyond. Job Overview Collaborates with the assigned clinical team to identify patients most likely to benefit from care coordination services, including assessing patients’ risk factors and the need for care coordination, clinical utilization management, and preventative care services. Responsibilities Essential Functions Takes the lead in ensuring continuity and consistency of care across the continuum (inpatient, emergency and ambulatory/outpatient) to ensure integrated delivery, including comprehensive discharge planning (in the hospital) and follow-up care (outpatient). Develops an effective working relationship with the Care Management Team to engage the patient/family to collaborate, advocate and problem-solve, supporting and enhancing functional ability while ensuring an appropriate and timely discharge plan. Daily monitoring of progress towards discharge plans and any adjustments needed due to changes in patient condition or family needs, prioritizing patients at highest risk for complication, admission or readmission. Educates patients/families with chronic illness about evidence-based standards of care, including self-management strategies. Identifies support needs for patients and their families, develops action plans, and provides guidance in initiating and overcoming self-management challenges. Educates patients and families about the health care system and facilitates relationship building between various settings. Ensures patients have access to prescriptions, durable medical equipment (DME), and other identified services. Contributes to problem solving within the team through communication, collaboration, data collection, consensus-building, and evaluating outcomes of treatment options, including tracking progress toward care plan goals and revising the plan as indicated. Advocates for patients to optimize health care needs, including safety, physical, legal and financial well-being. Refers patients to education regarding health care delivery and reimbursement systems, prescription drug programs, health & wellness programs, community agencies, housing options, and other services as appropriate. Works with IT resources (e.g., Allscripts Care Management, EMR) to facilitate registry reporting and maintenance of specified patient populations to improve disease outcome measures through evidence-based guidelines and clinical decision support tools, referral/test tracking, and preventive medicine reminders. Participates in clinical outcome measurement to identify strategies that promote population health. Ensures patient safety in the performance of job functions and supports the implementation of policies, procedures and standards. Maintains regular, punctual attendance consistent with Orlando Health policies and applicable laws and standards. Maintains compliance with all Orlando Health policies and procedures. Demonstrates analytical and teamwork skills, with the ability to prioritize and work independently. Provides care appropriate to the age of the patients served, with knowledge of growth and development across the life span. Maintains awareness of medical/legal issues, patient rights and compliance with regulatory and accrediting standards. Qualifications Education/Training Bachelor’s degree in Social Work, Psychology, Sociology, or other related field. Experience One (1) year of direct clinical experience with an emphasis on the population to be served in the assigned area, or a completed internship in healthcare. Senioriy level Entry level Employment type Full-time Job function Other Industries Hospitals and Health Care Interested candidates may apply to other related roles at Orlando Health in the area.
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Join to apply for the
Care Coordinator, Social Worker I - Bayfront Hospital, St. Petersburg, Florida
role at
Orlando Health Position Overview Site:
Orlando Health Bayfront Hospital Location:
St. Petersburg, Florida Department:
Case Management Position:
Care Coordinator, Social Worker I About Orlando Health Bayfront Hospital Orlando Health Bayfront Hospital is a comprehensive tertiary care facility that has served St. Petersburg and the surrounding communities for more than 100 years. A teaching medical center, the 480-bed hospital’s areas of expertise include heart and vascular, digestive health, orthopedics, surgical services, robotic surgery, rehabilitation, neurosciences, maternity care, emergency services and trauma care. The hospital’s Level II Trauma Center is the only adult trauma center in Pinellas County. In partnership with Johns Hopkins All Children’s Hospital, it is one of Florida’s 13 state-certified Level III Regional Perinatal Intensive Care Centers. The hospital has received recognitions such as the Today Top Workplaces award for 2025 and an “A” Hospital Safety Grade for Spring 2025 from The Leapfrog Group. Orlando Health Bayfront Hospital is part of the Orlando Health system of care, which includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities across Florida and beyond. Job Overview Collaborates with the assigned clinical team to identify patients most likely to benefit from care coordination services, including assessing patients’ risk factors and the need for care coordination, clinical utilization management, and preventative care services. Responsibilities Essential Functions Takes the lead in ensuring continuity and consistency of care across the continuum (inpatient, emergency and ambulatory/outpatient) to ensure integrated delivery, including comprehensive discharge planning (in the hospital) and follow-up care (outpatient). Develops an effective working relationship with the Care Management Team to engage the patient/family to collaborate, advocate and problem-solve, supporting and enhancing functional ability while ensuring an appropriate and timely discharge plan. Daily monitoring of progress towards discharge plans and any adjustments needed due to changes in patient condition or family needs, prioritizing patients at highest risk for complication, admission or readmission. Educates patients/families with chronic illness about evidence-based standards of care, including self-management strategies. Identifies support needs for patients and their families, develops action plans, and provides guidance in initiating and overcoming self-management challenges. Educates patients and families about the health care system and facilitates relationship building between various settings. Ensures patients have access to prescriptions, durable medical equipment (DME), and other identified services. Contributes to problem solving within the team through communication, collaboration, data collection, consensus-building, and evaluating outcomes of treatment options, including tracking progress toward care plan goals and revising the plan as indicated. Advocates for patients to optimize health care needs, including safety, physical, legal and financial well-being. Refers patients to education regarding health care delivery and reimbursement systems, prescription drug programs, health & wellness programs, community agencies, housing options, and other services as appropriate. Works with IT resources (e.g., Allscripts Care Management, EMR) to facilitate registry reporting and maintenance of specified patient populations to improve disease outcome measures through evidence-based guidelines and clinical decision support tools, referral/test tracking, and preventive medicine reminders. Participates in clinical outcome measurement to identify strategies that promote population health. Ensures patient safety in the performance of job functions and supports the implementation of policies, procedures and standards. Maintains regular, punctual attendance consistent with Orlando Health policies and applicable laws and standards. Maintains compliance with all Orlando Health policies and procedures. Demonstrates analytical and teamwork skills, with the ability to prioritize and work independently. Provides care appropriate to the age of the patients served, with knowledge of growth and development across the life span. Maintains awareness of medical/legal issues, patient rights and compliance with regulatory and accrediting standards. Qualifications Education/Training Bachelor’s degree in Social Work, Psychology, Sociology, or other related field. Experience One (1) year of direct clinical experience with an emphasis on the population to be served in the assigned area, or a completed internship in healthcare. Senioriy level Entry level Employment type Full-time Job function Other Industries Hospitals and Health Care Interested candidates may apply to other related roles at Orlando Health in the area.
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