Case Management Social Worker - Pediatrics

Job Summary
This position is responsible for working closely with the Health Services team and directly with members to assist with psychological and social care coordination needs. The Masters prepared Case Management (CM) Social Worker addresses not only the psychosocial needs of members but members' linkage and eligibility to government programs, social services, and community resources. The CM Social Worker's responsibilities include but are not limited to communicating with members, providers, and community-based organizations; transitioning members from skilled nursing facilities to alternative living arrangements; assisting with housing resources; referring to funding sources, and identifying community resources to maintain members in the least restrictive environment.

CM Social Workers in the Pediatrics (Peds) Program responsibilities also include assisting pediatric members with special healthcare needs and their families to transition into adulthood and acting as a liaison between the Health Services Pediatric staff and California Children's Services (CCS) Medical Therapy Program staff.

Duties and Responsibilities

• Develop individualized, member-centered care plans
• Maintain a high level of ethical conduct and adhere to HIPAA and confidentiality regulations
• Based on needs identified in an assessment, arranges, coordinates, and monitors services from different providers to serve member needs.
• Participate in continuing education activities, remaining knowledgeable in the area(s) of expertise
• Conduct follow-up; monitor member's needs and care plan; identify and develop a support system for the member.
• Perform other duties as assigned
• Responsible for the member-centered assessments/reassessments, covering psychosocial, rehabilitation, and environmental concerns
• Consult and cooperate with community systems to facilitate linkage, referral, advocacy, and follow-up with a focus on attaining care plan goals
• Provide resources and linkages to crisis management
• Consult with Medical Director or the Nurse Care Manager as warranted on medical issues
• Maintain an active caseload providing interventions as needed within the area of expertise and limits
• Recommend improvements for the member's functional level
• Evaluate the potential member as a total person and identify the functional limitations that impede independent living
• Refer members to specialized programs, such as Tri-County Regional Center (TCRC), County Behavioral Wellness (Health), Public Health, and Family Service Agency (FSA)

CM Social Worker - Peds additional duties and responsibilities:

• Participate in CCS Medical Therapy Unit Conferences and address identified psycho-social issues of members and their families
• Assist CCS members and their families with transition care planning from age 16 until 21 when members age out of CCS

Education and Experience

Required

• Experience with providing services and addressing problems of children and young adults with disabilities and special healthcare needs
• A minimum of a Master's degree in Social Work, Clinical Psychology, or Psychology.
  • A concentration in Gerontology, Pediatrics, Public Health, Substance Abuse, Mental Health, or other related fields is preferred.
• A minimum of three (3) years of clinical work experience in the above field
• An active, unrestricted Licensed Clinical Social Worker license substitutes for two years of work experience
• A concentration in Gerontology, Pediatrics, Public Health, Substance Abuse, Mental Health, or other related fields is preferred.

Desired

• Experience in developing member-centered individualized care plans
• A Minimum of one (1) year in a managed care or health plan setting, Medi-Cal or Medicaid preferred
• A minimum of one (1) year in case management and care coordination preferred