Support the overall improvement of members health status in collaboration with the case managers and physicians by identifying and referring members to community resources, counseling and/or support services. Educate patients about entitlement programs, legal issues or other services relevant to social work practice skills and knowledge.
Develop, coordinate and evaluate a social worker assessment for identified members.
Consult and coordinate with the case manager and physician to identify member issues and develop a plan to resolve the issues
Assess the members progress to social work intervention and community services provided through on site visits and POD review sessions upon invitation
Assist the Case Manager with psychosocial needs assessment and identification of appropriate resources.
Identify and refer members to community resources, counseling, and/or support for the member and/or authorized representative, as needed
Document all activities as appropriate, including but not limited to member assessment, communication with case managers, PCP or issues related to guardianship, abuse/neglect.
Educate the member and/or authorized representative about entitlement programs (i.e., Medicaid, Social Security), legal issues (i.e. guardianship, advanced directives) and assisting in the application process as needed
Assist the member and/or authorized representative with long-term care planning and of end of life decisions and options as needed
Provide member support as needed throughout hospice period.
Provide member receiving hospice services with information regarding appropriate community resources.
Travel may be required.
May have to work flexible hours.
" Qualifications"
Masters Degree in Social Work or Psychology required
Minimum of 3 years of practice as a Licensed Masters Social Worker or Limited License in Psychologist required
Minimum of two (2) year to be in home health care and/or medical case management preferred
Current unrestricted Licensed Masters Social Worker or Limited License in Psychology in the State of Michigan is required
Knowledge of clinical programs and P&P, HIPAA regulations and guidelines, American Disability Act, URAC standards (CM SW only) and clinical ethics
Motivational interviewing skills as well as experience in performing assessments and interventions
Knowledge of Medical Policy, CM and DM principles and alternate levels of care
Knowledge of BCBSM/BCN benefits
Basic computer applications/Microsoft word/typing required
CM, CCM Admin Modules and Care Advance systems
VDA, Virtual Desk Top (work from home)
Ability to engage and motivate the member or member representative, mentor and train
Identify existing and or potential psychosocial and quality of care issues
Interact and collaborate with multidisciplinary team while advocating on members behalf
Providing effective written and verbal communication/feedback
Organizational skills and ability to prioritize and have a flexible work schedule
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
Equal Opportunity Employer–minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity
Please see job description for required skills.
