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  Nestled in San Francisco's Excelsior neighborhood on a nine-acre campus, the San Francisco Campus for Jewish Living (SFCJL) is the leading senior services organization in Northern California. Our continuum of care includes: the Frank Residences assisted living and memory care; the Jewish Home and Rehabilitation Center, offering long-term skilled nursing, short-term rehabilitation, an acute geriatric psychiatric unit for adults over the age of 65; and our Foundation. Founded in 1871 and formerly known as the Jewish Home, our legacy grounds us as our vision propels us forward. Today, we've evolved to support more than 2,500 older adults each year through innovative, comprehensive programs rooted in the Jewish values of compassion, community, and excellence. We are equally proud of our inclusive culture, where 950 team members of diverse faiths and backgrounds work together in shared purpose. WHY WORK WITH US Mission-driven nonprofit organization  Competitive compensation and comprehensive benefits Meaningful work that positively impacts the lives of older adults every day Inclusive community, welcoming to all (you do not need to be Jewish to live or work here) Supportive, team-oriented environment Opportunities for professional growth and development Collaborative leadership focused on enhancing the employee experience   POSITION SUMMARY As a Transitional Care Coordinator (TCC), you will provide psychosocial support to patients and their families, facilitate discharge planning, meet documentation requirements, and function as a member of the interdisciplinary care team at the Jewish Home & Rehab Center. This role supports the planning, organization, implementation, and evaluation of Social Services operations in accordance with federal, state, and local regulations, as well as the facility’s established policies and procedures. KEY RESPONSIBILITIES Coordinate with the interdisciplinary team and other departments in the provision of social services and discharge planning. Complete comprehensive psychosocial assessments of patients within the appropriate timeframe. Act as a liaison between patients, their families, internal departments, and community referral partners throughout the patient’s stay in Short-Term Rehabilitation and Long-Term Care. Assist patients and families in accessing concrete services and resources. Demonstrate knowledge of and ability to utilize community resources effectively. Respond to crisis situations involving patients, families, and staff with guidance from supervisors. Facilitate individual counseling for patients and families as needed. Participate in the development of patient care plans and establish appropriate goals and treatment interventions for social services. Encourage residents and responsible parties to participate in care planning and attend care plan meetings. Maintain accurate and timely documentation in compliance with federal and state regulations and Jewish Home policies, including but not limited to Initial Assessments, Psychosocial/Mental Status Assessments, Care Plans, Social Service Progress Notes, and Discharge Planning documentation. Maintain confidentiality of all patient and facility information. Serve as a patient advocate and ensure patients are informed of their rights, responsibilities, and insurance benefits, as well as any changes that may affect them. Perform other duties as assigned by the Director of Social Services. JOB DETAILS Pay Rate: $28 – $35 per hour Hours: Full-Time,  40 hours per week Shift Schedule: 8:00 AM - 5:00 PM Days Off: Saturday and Sunday Working Days: Monday through Friday REQUIRED QUALIFICATIONS Bachelor’s degree in Social Work or a related human services field, including but not limited to sociology, gerontology, rehabilitation counseling, or psychology. Minimum of one (1) year o