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Health Services WellCare - Social Work Careers

Clinical Social Worker Job

Full Job Title: Clinical Social Worker

Job Number: 1704120

Location: Hazard, KY

Date Posted: 9-5-2017

"PLEASE NOTE: THIS IS A WORK FROM HOME OPPORTUNITY"
"POSITION CAN RESIDE IN ONE OF THE FOLLOWING COUNTIES: PIKE, FLOYD, MAGOFFIN, KNOTT OR JOHNSON"

Coordinates the socio economic needs and service of selected member populations across the continuum of illness. Interviews, coordinates and plans activities and behavioral routines to meet the social and medical needs of members and their families. May manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Provides support and/or intervention and assists members in understanding the implications and complexities of their current medical situation and/or overall personal care. May assumes a behavioral health leadership role within the interdisciplinary team to achieve optimal clinical and resource outcomes. Works with the Case Management to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of the Member.

REPORTS TO: SR. MANAGER, FIELD SERVICE COORDINATION
DEPARTMENT: KENTUCKY HEALTH SERVICES-STATE
POSITION LOCATION: HAZARD, KY 41701
Essential Functions:
  • Participates in and supports developed care plans for members with high level acuity needs utilizing social service expertise to evaluate the members need for alternative services and third party needs.
  • Outreaches to members telephonically and/or in-person and coordinates member's case management services.
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address/support medical needs.
  • Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
  • Provides telephone follow-up to ensure members have seen their PCP and are completing their treatment plan or preventive care services a defined by the PCP or guidelines.
  • Coordinates community resources with emphasis on the development of natural support system.
  • Coordinates benefits, regulations, laws and public entitlement programs.
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
  • Assists in obtaining benefits for members through community resources when benefits are exhausted or not available.
  • May manage members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability.
  • Acts as team SME in order to achieve optimal clinical and resource outcomes.
  • Performs other duties as assigned.
Education:
  • Master's Degree in Social Work (MSW) is required
Experience:
  • 2-4 years relevant social work and/or health care experience with client care coordination responsibilities (preferably in long-term care)
  • Experience in a managed care environment
Licenses/Certifications:
  • LSW, LCSW, LMHC, LPC, LMFT, PsyD is required
Special Skills (e.g. 2nd language):
  • Ability to work independently, handle multiple assignments and prioritize workload
  • Communicates effectively in person and by phone
  • Advanced ability to communicate on any level required to meet the demands of the position
  • Ability to create, review and interpret treatment plans
  • Technical Skills/Requirements:
  • Proficient in Microsoft Office including MS Outlook, MS Word and MS Excel is required
  • Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties is required

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Last Updated On: 12/9/2015