Social Worker Case Manager - 216041

Medix Healthcare is currently hiring fully remote social worker to work as a case manager for a MTLC in New York. This role will be strictly telephonic (no field visits). May be required to go to the office 1-2 times a year, other than that, it will be remote. The Social Worker will provide care management through a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet member’s health needs through communication and available resources, while promoting quality cost-effective outcomes.

Schedule - Monday - Friday (8a-5p) EST

Licensure: License and current registration to practice as a Licensed Social Worker in New York State preferred.

Job Duties

• Assesses, plans and provides intensive and continuous care management across acute, home, and long-term care settings. Develops and negotiates care plans with members, families and physicians.
• Assesses a person’s living condition/situation, cultural influences, and functioning to identify the individual’s needs; develops a comprehensive care plan that addresses those needs.
• Assesses an enrollee’s eligibility for Program services based on his or her health, medical, financial, legal and psychosocial status, initially and on an ongoing basis.
• Plans specific objectives, goals and actions designed to meet the member’s needs as identified in the assessment process that are action-oriented, time-specific and cost effective.
• Implements specific care management activities and or interventions that lead to accomplishing the goals set forth in the plan of care.
• Coordinates, facilitates and arranges for long term care services in the home and community-based sites, such as adult day care, nursing homes, rehab facilities, etc. Arranges for on-going nursing care, service authorization and periodic assessment.
• Collaborates and negotiates with interdisciplinary teams, health care providers, family members, and third party payors, as applicable, across all health settings to ensure optimum delivery and coordination of services to members.
• Monitors care management activities, services, and members’ responses to interventions, to determine the effectiveness of the plan of care and the utilization of services.
• Evaluates the effectiveness of the plan of care in reaching desired outcomes and goals; makes modifications or changes in the plan of care as needed.
• Identifies trends and needs of groups in the community and plans interventions based on these identified needs.
• Provides care management services across sites and collaborates with appropriate facility discharge planner and/or HCC when members are transitioned between settings.

Education:

• Master’s degree in Social Work

Experience:

• Minimum of three years MSW experience required.
• Minimum of two years in a case management and/or community based environment preferred
• Hospital experience with discharge planning
• Clinical expertise in geriatrics, Long Term care and Managed care experience