Looking for an energetic individual who knows Social Work within a sub-acute/long term care environment. Responsible for: Identifies cognitive impairments, signs of mood problems, and psychosocial needs and follows-up as needed. Communicates effectively with the interdisciplinary team, patients, families, and community agencies • Maintains accurate and timely documentation, including, but not limited to, Advanced Directives, Minimum Data Set, Social Service History and Assessment, Raps, Care Plans, Social Service Progress Notes, PASARR and Discharge Planning documentation, Behavior Tracking and monitoring of cognitive and psycho-social changes, and psych services. Coordinates care conferences. Facilitates communication among patient, family, and int