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Post Acute Coordinator - LSW, LCSW

Primary Location Honolulu, Hawaii Job Number 1095862 Date posted 12/19/2022
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$15,000 sign-on bonus eligible position!

Provides care coordination to identified members in the extended care facilities (ECFs).  Develops a client focused discharge plan collaboratively with the long-term care providers and other decision makers. Assists with access to medical care and services upon ECF discharge. Communicates and coordinates health care services needed upon ECF discharge with the post-acute care team, professional health team members and community agencies.

Essential Responsibilities:

  • Provide care coordination across the continuum by assessing health care and appropriate needs.

  • Maintain documentation by using KPHC electronic health record.

  • Provides information, resources identification and referral services including but not limited to Social, Emotional, and Behavioral Difficulties (SEBD)/Severely Mentally Ill (SMI), Adult Protection Services (APS), and Developmental Delayed/Intellectual Disability (DD/ID).

  • Serves as resource person to members, families, physicians, Staff and community agencies, institutional facilities, and extended care facilities (ECFs) for matters pertaining to health care services, community living, appropriate placement setting, and / or request for self-directed assistance.

  • Works closely with post-acute team, professional health team members and community agencies.

Basic Qualifications:



  • Minimum one (1) year social work experience.



  • Masters degree in social work OR a minimum six (6) years of experience in a directly related field.


License, Certification, Registration

  • Licensed Clinical Social Worker (Hawaii) OR Licensed Social Worker (Hawaii)

  • Basic Life Support required at hire from American Heart Association


Additional Requirements:

  • Demonstrates knowledge of and skill in oral communication, written communication, problem solving/assessment, teamwork, team building/team leader, group process facilitation, statistical data analysis, documentation accuracy, customer service, interpersonal relations, creativity/innovation, adaptability, decision making and conflict resolution.


Preferred Qualifications:

  • One (1) year of care coordination/case management experience preferred.

  • Home health experience preferred.

  • Long Term / Post-Acute experience working preferred.

  • Demonstrated ability in networking with community agencies preferred.

Primary Location: Hawaii,Honolulu,Moanalua Ancillary Building Scheduled Weekly Hours: 40 Shift: Day Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat Working Hours Start: 12:01 AM Working Hours End: 11:59 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-HI-01|NUE|Non Union Employee Job Level: Individual Contributor Department: Moanalua Medical Center - Utilization Management - 1208 Travel: Yes, 25 % of the Time At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.