Job Description

Degreed Social Worker-Health Plan



Job ID #1632875


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About this Role


Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.

Job details


$23.96 / hour


Wichita Falls, Texas

Profession: Degreed Social Worker



Facility Type: ???



Specialty: Health Plan



Division: MedFi



Start Date: 10/21/2024

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Responsibilities

Develops and continuously assesses ongoing long-term care plans / service plans


Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team


Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals


Monitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable


Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations


Reviews referrals information and intake assessments to develop appropriate care plans / service plans


Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed


Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines


Provides and/or facilitates education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits


Acts as liaison and member advocate between the member/family, physician, and facilities/agencies

Required Qualifications

2+ years social work experience


Strong computer skills - MS office


Ability to travel - drivers license required


Bachelor's degree in Social Work, Health Services, Behavioral Science or related field


SW license or nursing license preferred


Social Service/ Social Work/ Care Management / Services Coordination experience preferred

Job Tags

Work experience placement,

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