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Social Work Care Manager
Company | Fallon Health |
Address | Worcester, MA, United States |
Employment type | FULL_TIME |
Salary | |
Category | Insurance |
Expires | 2023-05-19 |
Posted at | 1 year ago |
Overview
- May collaborate with staff on site to facilitate communication between Fallon and community based teams
- With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs while completing program assessments and working with the Care Coordinator to ensure the member approves their care plan
- Participates in monthly supervision and one on one meetings with the manager
- Works with members of the Utilization Management Department assisting with difficult or complex care delivery or discharge planning needs for members
- Provides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives
- Maintains an ongoing awareness of clinical, social, and financial resources available in the community as well as State/Federal and National Resources and connects and advocates for members as appropriate
- Monitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member’s health care goals and needs
- Assists with care coordination with community Partners to engage in Interdisciplinary team meetings
- Actively participates in internal clinical rounds and huddles
- Works with Nurse Case Managers and Navigators to coordinate a continuum of care for members consistent with the member’s health care goals and needs
- Performs other responsibilities as assigned by a member of the Clinical Integration Leadership Team
- Actively participate with Beacon team and collaborate on high risk members to decrease utilization
- Certification in Case Management strongly desired
- Active, unrestricted license as a Licensed Clinical Social Worker or Counselor in Massachusetts; reliable transportation
- Previous experience working at a Managed Care Organization preferred.
- Four years of experience working with the following: the chronically ill, SPMI, and substance use populations required.
- Experience working with provider groups such as medical and/or mental health providers required.
- Experience working and providing collaborative care management interventions with various State Agencies such as DMH, DDS, DCF, DYS required.
- Background working with all age groups preferred.
- Experience working in a multi-disciplinary care team required.
- Experience and comfort conducting face-to-face visits with members in the community and in home settings required.
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