Social Worker

Implements and coordinates all care management activities related to the long-term care program including consultant referrals, home care visits, use of community resources and outpatient services.
1.Graduate of an accredited school with a Bachelor’s Degree in Social Work, Psychology, Sociology, Nursing, Gerontology or a related field.
2.Experience in geriatric care management
3.Three to five years of geriatric experience.
4.Minimum of two years recent care management
5.Managed Care organization experience a plus

This position requires an extensive knowledge of the health care industry and its data. Requires the ability to work independently and do involved problem and patient management resolution. Computer literate, proficiency in Word, Excel, E-mail, Internet Search. Effective written and oral communication skills. Ability to follow through on assigned tasks with limited supervision. Excellent time management and organizational skills.

1.Ongoing monitoring of all long-term care cases to ensure appropriateness of care management services.
2.Coordinates the provision of all care management services using the most appropriate and effective providers.
3.Determines benefits available and cost-effectiveness of alternative services.
4.Works closely with provider relations to negotiate rates for non-contracted services.
5.Works closely with CARES, admission, concurrent review coordinators, and other staff on patients requiring discharge planning and/or care management services, and other department staff
6.Accurately enters all CM activity including care plans, assessments and authorized services into member files.
7.Coordinates the transfer of medical records.
8.Develops a strong working relationship with CARES, hospital social workers, and knowledge of community resources and alternate funding arrangements for members when services are not available under program benefits
9.Educates provider relations staff on care management services in order to ensure appropriate services for members
General Responsibilities
REQUIREMENTS
1.Graduate of an accredited school with a Bachelor’s Degree in Social Work, Psychology, Sociology, Nursing, Gerontology or a related field.
2.Experience in geriatric care management
3.Three to five years of geriatric experience.
4.Minimum of two years recent care management
5.Managed Care organization experience a plus