Social Worker II

Geneia - Remote4.1

Full-timeEstimated: $61,000 - $75,000 a year
Geneia is a clinical, technological and analytics innovations company specializing in product development for population health management, health economics, health analytics and preventive medicine.

An exciting opportunity exists for a Social Worker. The Social Worker provides clinical care and services to the member using an interdisciplinary team approach through the completion of psychosocial assessments and the creation of a comprehensive care plan. Social workers manage appropriate members independently or co-manage with the RN care manager to address psychosocial, behavioral and clinical needs. Social workers provide counseling and referrals to community/local/state programs; collaborate with caregivers, providers, community agencies, behavioral health, and other resources to coordinate care to achieve member’s optimal health status.

The Social Worker is responsible for the co-management and/or oversight of a caseload of 150-200 moderate to high risk patients with complex medical/psychosocial needs.

Uses a collaborative process and serves as a liaison between the participant, family and significant others, physician(s) and other members of the treatment team.
Develops future-oriented goals and health actions that assist participants with the implementation of appropriate self-directed care decisions and support improvement in health and self-reliance.
Advocates for members and families by helping them to coordinate care and navigate resources to reduce barriers and meet personal care needs.
Using established criteria, analyzes and evaluates referrals for potential enrollment of Members into the Care Management Program. Conducts assessments to obtain information for a participant-centered plan of care and determination of acuity level, psychosocial status, & barriers to care. Obtains consent forms necessary for candidates accepted into the Case Management Program.
Applies established criteria for discharge and discharges the Member from the Care Management Program when the criteria are met.
Conducts all care management activities, including documentation, in accordance with established departmental policies and procedures.
Complies with all Clinical Management and corporate policies and procedures.
Documents all care management activities in the care management documentation system, according to established policies and procedures.
Builds relationships with members, their families, and implements interventions that move assigned members toward goals of improved self-management care and long term care outcomes of stabilization.
Identifies and reports quality of care issues in accordance with established departmental policies and procedures. Maintains member confidentiality at all times.
Attends company and departmental meetings and training sessions as required.
At least three (3) years’ clinical social work experience or five (5) years of behavioral health work experience required; One (1) year experience in care coordination preferred. Graduate from an accredited School of Social Work with an MSW (Master’s in Social Work) degree. Home state licensure required by the State Board of Social Work Examiners. Licensed Clinical Social Worker (LCSW) preferred. Case Management certification preferred. Subsequent to completing three (3) years in the position, the incumbent must obtain national certification as a case manager.
Possession of a valid driver’s license and the ability to travel to provider, facility, employer group and/or member locations using own vehicle, if appropriate.
Strong communication skills and the ability to positively interact with customers, peers, leadership, family members, caregivers, visitors, contracted agencies/personnel and the general public.
Knowledge of National Committee for Quality Assurance standards for case management organizations and CMSA standards and guidelines.
Knowledge of clinical and managed care principles and operations.
General knowledge of current and emerging medical treatment modalities and best practice guidelines with the ability to analyze and interpret medical and benefit coverage interrelationships.
Knowledge of adult learning principles, motivational interviewing and intrinsic coaching techniques.
Superior clinical process, critical thinking, and problem solving skills; and ability to handle critical situations.
Excellent written, oral communication, listening and organizational skills.
Ability to use computer system while conversing telephonically
Able to demonstrate strong customer service skills, including tact and diplomacy, both in person and telephonically when communicating with internal and external customers
Ability to influence and negotiate individual and group decision making, conflict resolution, and problem solving
Ability to appropriately prioritize workload and assignments and perform accurate, detailed and timely completion of assigned duties.
Ability to work autonomously and as part of an interdisciplinary team
Demonstrates sound judgment that affirms the rights and responsibilities of Member’s, families, health care professionals and health care organizations.
Ability to operate a personal computer (PC), including proficiency in Microsoft Word and Access.

Geneia is an Equal Opportunity Employer