Social Worker

We’re looking for a Social Worker, someone who’s ready to grow with our company. In this position, you’ll assess, plan, implement, monitor and evaluate the options and services required to meet an individual’s health needs. You'll provide comprehensive ongoing case management services to Health Plan members by coordinating and managing care of high risk members to meet multiple service needs across the continuum of care, ensure optimal member outcomes that address quality, service, customer satisfaction and cost effectiveness. You'll also assists the member/member's family in coping with illness by optimizing the member's/family's self-care abilities and support their consumer rights.

Think you’ve got what it takes?

Job Duties & Responsibilities

Assesses, develops, implements and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the member/family in internal and external settings 
Proactively identifies members in need of case management through clinical rounds, medical management staff referrals, consultation with primary HMO staff, medical director and PCP, parents, staff, home care staff, and other internal areas 
Comprehensively assesses member’s biophysical, psychosocial, environmental, discharge planning needs and financial status 
Participates in planning and coordinating services across the continuum of care and documents this plan in designated system 
Ensures provision of continuity of care needs as required and serves as advocate on behalf of members and families on an ongoing basis across the continuum of care 
Identifies problems/barriers/opportunities for intervention and provides resolution and revision of plans on an ongoing basis 
Routinely assesses member’s status and progress; if progress is static or regressive, determines the reason and proactively encourages appropriate adjustments in the care plan, providers and/or services to promote better outcomes 
Performs all necessary communication and documentation functions 
Communicates continually with members/families, medical staff, caregivers, and primary HMO staff to facilitate appropriate, timely, and cost effective care 
Collaborates with community health education/outreach organizations and providers to support overall health promotion of members 
Completes home visits and clinic or hospital visits with members as indicated 
Conducts provider and member education activities 
Educates providers on network compliance and policies and procedures, managed care and Medicaid 
Accurately assesses own learning needs and develops strategies to meet them and is motivated to utilize computer-based distance learning 
Stays informed of current healthcare developments to provide safe, quality social work  
Prepares and monitors outcome data to assist in identification of improvement opportunities 
Arranges and monitors appropriate care and services for members 
 

Skills & Requirements

Master's Degree Social Work required 
LMSW - Licensed Master Social Worker by the Texas Behavioral Health Executive Council (TBHEC) or LCSW - Licensed Clinical Social Worker by the Texas Behavioral Health Executive Council (TBHEC) or LMSW-AP - Licensed Master Social Worker - Advanced Practice by the Texas Behavioral Health Executive Council (TBHEC) required 
2 years clinical experience required 
Authorization to Release Personal Information must be signed prior to beginning work in this role. As a remote worker/road warrior, this consent allows us to disclose an employee’s home address for the purposes of geo-mapping.