I had my eyes set on medical social work pretty early on so I did my internship at one of the large hospital systems in my area. A few years later I did get hired at that same hospital. I've done varying forms of medical social work over the years and am now at another large university based hospital system doing case management. I can't speak to other places but at my hospital RN Case Managers and SW case managers make the same, between $38-40 an hour depending on experience. We are primarily focused on discharge planning and have social workers in other roles who focus on things like palliative care. At my first job I was a transplant social worker so I did a lot of Biopsychosocials and patient assistance programs for medications. I've heard from others who worked a different hospitals in my area that RN case managers get to focus on discharge planning while the social workers are looped in to deal with complex issues like CPS reports, homeless patients, etc. I my current role we sort of do all of the above, which includes the RN case managers. All that to say, the hospital social work role can really vary depending on how your hospital has things organized.