Licensed Social Worker Liaison

This position is based in Wyckoff Heights Medical Center Hospice IPU

JOB SUMMARY: The Hospice Clinical Liaison – Social Worker serves as the primary psychosocial liaison between Hospice of New York and assigned hospital partners. This role is responsible for building and maintaining strong professional relationships within hospital systems while providing patient- and family-centered support during the transition to hospice care.

The Clinical Liaison Social Worker works closely with hospital care teams, discharge planners, physicians, patients, and families to facilitate safe and timely discharge planning, educate on hospice services, and ensure smooth coordination of care. This position combines relationship management, psychosocial assessment, and hands-on support for patients and families navigating end-of-life decisions.

RESPONSIBILITIES

Patient & Family Support

• Meet with patients and families to provide education regarding hospice philosophy, services, and expectations of care.

• Conduct psychosocial assessments to identify emotional, social, cultural, and caregiver needs impacting discharge and care planning.

• Support families through goals-of-care discussions and end-of-life decision-making processes.

• Provide emotional support, counseling, and resource guidance during transitions from hospital to hospice care.

• Advocate for patient and family needs while promoting dignity and person-centered care.

Discharge Planning & Care Transition

• Collaborate with hospital discharge planners, case managers, and interdisciplinary teams to coordinate safe and timely hospice discharges.

• Facilitate discharge planning processes specific to hospice admission, ensuring alignment with patient goals and clinical recommendations.

• Coordinate communication between hospital staff and hospice teams to ensure continuity of care.

• Assist families with understanding next steps, available care settings, and hospice resources.

• Ensure required documentation and consents are completed to support efficient transitions.

Relationship Building & Hospital Account Management

• Build and maintain strong working relationships with hospital social workers, case managers, nursing staff, and physicians.

• Serve as the primary social work liaison and resource for hospice-related psychosocial questions and discharge planning needs.

• Provide ongoing education to hospital teams regarding hospice eligibility, services, and care transitions.

• Maintain regular visibility within assigned units to strengthen partnerships and support referral collaboration.

• Communicate facility trends, needs, and opportunities to the Director of Business Development.

Communication & Collaboration

• Facilitate effective communication between hospital teams, hospice clinicians, patients, and families.

• Collaborate with Hospice of New York interdisciplinary team members to ensure smooth admissions and continuity of psychosocial care.

• Address patient or family concerns related to expectations, services, or transition planning.

• Participate in team meetings and case discussions as needed to support patient-centered outcomes.

Documentation & Compliance

• Maintain accurate, timely, and comprehensive documentation in the EMR.

• Ensure documentation meets regulatory, organizational, and clinical standards.

• Maintain confidentiality and HIPAA compliance at all times.

• Utilize agency software systems and communication tools effectively.

Minimum Qualifications

• Master’s Degree in Social Work (MSW) from an accredited program.
• Current New York State LMSW or LCSW license required.
• Minimum two (2) years of experience in acute care hospital, discharge planning, or healthcare social work.
• Experience in hospice, palliative care, or home care preferred.
• Strong communication, counseling, and relationship-building skills.
• Ability to collaborate effectively with interdisciplinary healthcare teams.

Preferred Qualifications

• Experience in hospital-based liaison or transitional care roles.
• Knowledge of hospice philosophy, CMS hospice guidelines, and end-of-life care practices.
• Strong organizational skills and ability to manage multiple referrals and family interactions simultaneously.
• Proficiency with EMR documentation and Microsoft Office applications.

Work Environment & Role Expectations

• Primarily hospital-based with frequent direct interaction with patients, families, and hospital staff.
• Requires strong interpersonal skills, emotional intelligence, and professional presence.
• Role balances psychosocial patient support with relationship development and account management within assigned facilities.
• Focused on compassionate care, collaboration, and smooth transitions to hospice services.

The above statements describe the general nature and level of work performed by individuals assigned to this position. Duties may be modified based on organizational needs.

Pay: $70,000.00 - $100,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Work Location: In person