Social Work Care Manager (Medicare Dual Eligible Plan) - Remote

Network Health

Brookfield Wisconsin

United States

Social Services / Counseling
(No Timezone Provided)

Description

Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Social Work Care Manager for our special needs plan team. This individual provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The care manager advocates for and supports member care management needs by providing professional social work services and care management while coordinating benefits and resources.

Job Responsibilities:

  • Screens candidates for management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines.
  • Updates care plan to reflect progress towards goals; closes cases when expected goals/outcomes are achieved.
  • Provides information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
  • Evaluates and processes member referrals from physicians to other specialty providers
  • Assess, plans, facilitates and advocates for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
  • Works with members and families on self-management approaches using coaching techniques such as motivational interviewing
  • Educates the individual, his/her family and caretakers about case and condition management, the individual's health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes.
  • Facilitates the coordination, communication and collaboration of the individual's care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality.
  • Schedules visits with the individual and participates in facility based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning.
  • Stays abreast of current best practices and new developments
  • Other duties as assigned

Job Requirements:

  • Bachelors Degree in Social Work, or related field.
  • Four years work experience as a Social Worker or Case Manager.
  • Prior experience with Medicare or Managed Care preferred.
  • Experience working in behavioral health preferred.
  • Current licensure in the State of Wisconsin as a Certified Social Worker, or eligible to hold certification within 120 days of hire.
  • CAPSW, CISW preferred.

This role will case managing members who are Medicare/Medicaid dual eligible.

**This position is eligible to work remotely out of your home office in the state of Wisconsin. Must be able to meet home office/telecommuting standards which includes private workstation set up and adequate internet speed in order to work remotely.

Network Health is an Equal Opportunity Employer. We encourage applications from all backgrounds, communities and industries, and are committed to having a team that is made up of diverse skills, experiences and abilities. We are committed to equality and diversity within Network Health.

*WARNING: Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that Network Health recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our positions require that you first complete an online application.






Associated topics: addiction, case, clinician, disabilities, field, lcsw, mental, mental health, tirr, violence

Social Work Care Manager (Medicare Dual Eligible Plan) - Remote

Network Health

Brookfield Wisconsin

United States

Social Services / Counseling

(No Timezone Provided)

Description

Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Social Work Care Manager for our special needs plan team. This individual provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The care manager advocates for and supports member care management needs by providing professional social work services and care management while coordinating benefits and resources.

Job Responsibilities:

  • Screens candidates for management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines.
  • Updates care plan to reflect progress towards goals; closes cases when expected goals/outcomes are achieved.
  • Provides information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
  • Evaluates and processes member referrals from physicians to other specialty providers
  • Assess, plans, facilitates and advocates for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
  • Works with members and families on self-management approaches using coaching techniques such as motivational interviewing
  • Educates the individual, his/her family and caretakers about case and condition management, the individual's health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes.
  • Facilitates the coordination, communication and collaboration of the individual's care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality.
  • Schedules visits with the individual and participates in facility based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning.
  • Stays abreast of current best practices and new developments
  • Other duties as assigned

Job Requirements:

  • Bachelors Degree in Social Work, or related field.
  • Four years work experience as a Social Worker or Case Manager.
  • Prior experience with Medicare or Managed Care preferred.
  • Experience working in behavioral health preferred.
  • Current licensure in the State of Wisconsin as a Certified Social Worker, or eligible to hold certification within 120 days of hire.
  • CAPSW, CISW preferred.

This role will case managing members who are Medicare/Medicaid dual eligible.

**This position is eligible to work remotely out of your home office in the state of Wisconsin. Must be able to meet home office/telecommuting standards which includes private workstation set up and adequate internet speed in order to work remotely.

Network Health is an Equal Opportunity Employer. We encourage applications from all backgrounds, communities and industries, and are committed to having a team that is made up of diverse skills, experiences and abilities. We are committed to equality and diversity within Network Health.

*WARNING: Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that Network Health recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our positions require that you first complete an online application.






Associated topics: addiction, case, clinician, disabilities, field, lcsw, mental, mental health, tirr, violence