Description
We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.
You will function as a coordinator of care for members identified as having long-term rehabilitation and/or psychosocial needs due to birth defects, chronic conditions, illness, or injury.
Responsibilities
- Control comprehensive management of members with acute or chronic conditions, including case management activities that focus on quality of care, compliance, outcomes, and decreasing costs for individuals and communities.
- Implement initial and periodic assessments of the members enrolled in the Long-Term Care Program and/or case or disease management programs under limited supervision to determine the course of treatment.
- Apply in-depth knowledge of case management concepts, principles, and strategies in the development of an individualized case plan for enrolled members in case or disease management who are at risk of poor outcomes.
- Communicate updates and facilitate discussions with providers, primary care physicians, Medical Directors, pharmacists, and care management staff regarding the status of patients internally and externally.
- Identify opportunities to ensure the member receives all the necessary care allowed under the member's benefit plan in home or community settings.
- Provide information, resources, and education on social issues, mental health, and available services to raise awareness and empower individuals and communities.
- Develop complex, innovative programs designed to reduce admissions for acute and chronic members, increase community integration, and improve health outcomes for enrolled patients and outside individuals.
- Coach more junior colleagues in techniques, processes, and responsibilities of social work to improve capacity.
- Collaborate with community members, organizations, and policymakers to create opportunities for clients, address community issues, or raise awareness for specific issues.
Requirements
- Minimum years of experience in medical social work or case management.
- Comply with all state requirements in the state where job duties are performed.
- Willingness and ability to travel up to 25%-50% of the time in Wayne and Macomb Counties.
- Basic awareness of problem-solving and decision-making skills.
- Basic awareness of digital literacy skills.
- Basic knowledge of medical terminology.
- Ability to deal tactfully with customers and the community.
- Ability to handle sensitive information ethically and responsibly.
- Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.
- Ability to function in a clinical setting with diverse cultural dynamics of clinical staff and patients.
Preferred Qualifications
- Behavioral health experience.
- Bilingual in Spanish or Arabic.
Educational/Licensure Requirements
- Master's Degree in Social Work as required by state law.
- LMSW.
Benefits
- Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources.