The Acute Care Navigation Social Worker intervenes with patients who are psychosocially complex, have Social Determinants of Health (SDOH) needs, and/or require assistance with transitions of care or discharge planning. In addition, the Social Worker/Discharge Planning Coordinator offers supportive intervention (i.e., trauma, terminal diagnosis, mental health etc.) to patients and caregiver(s) and coordinates and facilitates the development of a discharge plan of care for high-risk/complex patient populations. They may self-refer or receive referrals for patients from interdisciplinary team members and are responsible for collaborating with the care team (Physicians, Nurses, RN Acute Care Navigators, Care Navigation Coordinators, Contracted Vendors, etc.) and escalating appropriately to ensure their assigned patients receives exceptional care and avoid unnecessary delays in care or discharge.