Health First Social Worker MSW - Clinical Operations, Health First Health Plans, Full Time in Rockledge, Florida
_POSITION SUMMARY_ To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by coordinating the psychosocial care and services for assigned/referred members in collaboration with the member, family, physician, patient care team, and payers. The Social Work Case Manager utilizes advanced psychosocial skills to facilitate the coordination of care through assessment, planning, intervention, and evaluation. The Social Work Case Manager facilitates and evaluates the effective utilization of resources, quality, and community services. _ _ _PRIMARY ACCOUNTABILITIES_ _No Harm/Quality_ * Assess social service referrals for appropriateness and make the necessary recommendations for plan of care. * Conduct, by phone or in person, comprehensive biopsychosocial assessment and reassessments of identified members who are either high risk or in need. * Engage in timely, member centered care planning, care plan implementation, and care monitoring. * Coordinate care to promote proper care access and care continuity, especially during transitions of care. Care may address the individualized health, behavioral, or social needs of the member. * Collaborate with other members of the health care team, the member, and/or their designated representative. * Engage in ongoing interdisciplinary, intra-organizational, and inter-organizational meetings. * Initiate, facilitate, and participate in care conferences * Serve as a liaison to HFHP partners, not limited to governmental agencies and community organizations. * Provide consultation and education to the care team members of other disciplines to promote member centric care. * Document, in a timely manner, all case management activities in accordance with regulatory, legislative, statutory, and organizational requirements. * Participate in ongoing practice and program evaluation and improvement. * Adhere to National Patient Safety Goals. * Ensure compliance with regulatory standards at the state and federal level. * Identifies risk management and quality issues and intervenes or refers as indicated. _Customer Experience_ * Reinforce and document education provided to member or representative on psychosocial aspects of care and expected outcomes * Provide and document education to members of the team regarding appropriate services and referrals available for the situation at hand. * Maintain and improve clincials skills related to therapeutic methods, developmental theories, and disease processes. * Participate in the education of the healthcare team members on case management and current healthcare economic issues affecting acute care. * Maintain current knowledge and awareness of payer/reimbursement practices and the regulations affecting patient care. * Initiate appropriate referrals to Ethics Committee, Risk Management, DCF, etc. as appropriate. * Participate in resolution of issues surrounding guardianship, power of attorney, etc. as appropriate. * Provides education and/or material regarding patient’s rights, informed consent, advanced directives, etc. as appropriate. * Drive to a member’s at home or in a facility * Adhere to the I-CARE Values. _Stewardship_ * Communicate pertinent findings and care recommendations to appropriate team members. * Participate in patient care conferences as required. * Recommends supportive and therapeutic interventions as indicated to ensure a cost effective, safe, and efficient plan of care and quality patient outcomes. * Collaborate with other team members to communicate all plans of care, discuss any barriers, and coordinate patient outcomes.
_QUALIFICATIONS REQUIRED_ * MSW degree from a Council on Social Work accredited school or Master’s degree in a related filed with appropriate experience. * 1-3 years social work experience * Case Management experience preferred * Acute Care experience preferred * Medical Terminology understanding * Computer experience * Reliable transportation and valid driver’s license
Job: *Social work
Organization: *HF Administrative Plan Inc
Title: Social Worker MSW - Clinical Operations, Health First Health Plans, Full Time
Location: Florida - Brevard County-Rockledge
Requisition ID: 039755