Required Skills: Conduct initial evaluation, Develop plan of care to meet patient/caregiver needs, Establish and revise goals, Collaborative care, Coordinates with internal and external team members, Documents pertinent information to facilitate care coordination, Participates in care conference activities, Discharge Summary, Documentation according to plan of care, Documentation of care delivery, plan, goals, etc, Documentation of patient/caregiver teaching/learning, Documentation reflects understanding of coverage criteria, Documents patient response, Educates patient/caregiver to facilitate discharge, Provide / reinforce individualized patient/caregiver education, Medicaid, Medicare, Care coordination, Plan of Care. Aya Healthcare has an immediate opening for the following position: LMSW (Licensed Masters of Social Worker) in Portland, OR.We’ll work with you to build the healthcare career of your dreams.