Licensed Master Social Work Case Manager

The Licensed Masters Social Work Case Manager will work in the Clinical Services and Population Health area, providing support activities for members, coordinating with departments, providers, and community organizations to promote effective, efficient care.

Location: United States

Responsibilities

• Case Management: Assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet an individual’s health needs through the use of plan benefits and community resources to facilitate appropriate cost effectiveness and cost containment measures are met.
• Communication: Serves as a liaison facilitating a collaborative process to promote quality of care, cost effectiveness, accessibility and appropriateness of service levels.
• Compliance: Practices within the scope of licensure and adheres to policies, procedures, regulations, URAC standards and individual state regulations; making decisions to ensure compliance, appropriate level of care, and patient safety.
• Knowledge: Remain current with up-to-date social work licensing requirements and continuing education.
• Other duties as assigned.
• Serves as a resource for non-clinical staff.
• Travel: Travel to site or home visits may be required. Valid driver’s licenses is required.
• Workflow: Proactively work with referrals from multiple sources to identify appropriate candidates for case management, explaining services ensuring voluntary agreement of services and maintaining a minimum patient caseload in a timely matter.

Requirements

• Master’s degree in Social Work.
• Licensed Master Social Worker (LMSW) with current active state license in good standing in the state(s) where job duties are performed required.
• Case Management Certification required. If certification is not obtained prior to employment, must test successfully within three (3) years.
• Valid Driver's licenses.
• Minimum two (2) years' clinical practice experience in direct clinical care with patients in a hospital, facility or community-based environment.
• Minimum two (2) years' experience in case management, home health, critical care, social work, discharge planning, or utilization review.

Additional Information

• This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.
• Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.
• Employment Type: Regular
• ADA Requirements: 2.1 General Office Worker, Semi-Active, Campus Travel - Someone who normally works in an office setting or remotely, periodically has lifting and carrying requirements up to 40 lbs and routinely travels for work within walking distance of location of primary work assignment as essential functions of the job.