Bilingual Spanish Social Worker, Care Management (Riverside)

SCAN Health Insurance•Riverside, CA

23h•$39 - $56•Hybrid

About The Position

This field/remote role in Riverside, CA & surrounding areas supports high-risk members by providing person-centered interventions for serious mental illness, substance use disorder, and behavioral barriers to care. The role involves collaborating with the care team to assess, develop, and implement care plans, addressing health, behavior, and psychosocial needs through telephonic, virtual, or in-person visits. The focus is on holistic support to enhance independence and prevent unnecessary healthcare events, including ER visits and hospital admissions. The organization, SCAN, is a nonprofit health organization founded in 1977, serving over 500,000 people across multiple states with a mission to improve care for older adults. They are committed to combining compassion with discipline, innovation with stewardship, and growth with integrity, building the future of care for older adults.

Requirements

Graduate or Advanced Degree required in Social Work.
Licensed Clinical Social Worker; CCM preferred.
3-5 years managed care, healthcare environment, or mental health case management.
2 + years working with seniors and working remotely strongly preferred.
Technical expertise - Advanced analytical skills
Problem Solving - Basic problem-solving skills
Communication - Good communication and interpersonal skills
Spanish speakers are strongly preferred.
Strong interpersonal skills, including excellent written and verbal communication skills.
Strong organizational skills.
Strong critical thinking skills.
Ability to collaborate effectively with a multidisciplinary team.
Ability to appropriately maintain confidentiality.
Ability to communicate complex medical information with simplicity and kindness and build strong rapport.
General understanding of NCQA standards, CMS and DHCS regulations
BILINGUAL- Must be bilingual in English/Spanish. (Test will be administered to assess proficiency.)
Tuberculosis Screening Policy: If selected for this position, your job offer with SCAN will be contingent on providing proof of Tuberculosis screening upon hire or providing proof of a negative screening within the last year. If you have a disability/medical reason or sincerely held religious belief that prevents you to provide information required in this policy, SCAN will initiate and engage in the interactive process to evaluate what, if any, reasonable accommodations may be available.
A background check is required.

Nice To Haves

CCM preferred.

Responsibilities

Conduct comprehensive assessments to identify chronic conditions and psychosocial challenges affecting independent living, prevent utilization and support member’s overall goals of care.
Manage and provide targeted support for members with serious mental illness, substance use disorder, and behavioral barriers to care, including those identified as high-risk, ensuring comprehensive care and appropriate interventions.
Ensure the clinical appropriateness of member-centered care plans by evaluating assessment findings against evidence-based guidelines, clinical reasoning, and best practices.
Integrate clinical insights and community standards to develop comprehensive and effective care strategies.
Provide education and coaching surrounding behavioral and mental health treatment, interventions, and pharmacological approaches.
Work with members in the prevention of illness, promotion of health, and management of member’s adjustment to chronic health problems.
Strong collaboration with internal and external providers, specifically with BH/MH vendors and programs.
Serve as the key point of contact for complex behavioral health cases to assist with care coordination and act as Subject Matter Expert (SME).
Exhibit comprehensive member engagement and patient activation skills with the ability to communicate complex medical and behavioral health interventions cohesively with overall plan of care.
Actively participates in interdisciplinary planning and case conference meetings to ensure person centered care and to ensure member receives support following discharge from an inpatient or institutional setting.
Build strong working relationships with the Medical Groups, vendors, and community organizations.
Utilizes department desktop procedures, workflows, job aids and training material.
Identifies barriers to work processes and brings to the attention of the supervisor/manager.
Actively Adheres to all quality, compliance, and regulatory standards.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base salary range: $38.61 to $55.86 per hour
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
Excellent 401(k) Retirement Saving Plan with employer match and contribution
Robust employee recognition program
Tuition reimbursement
An opportunity to become part of a team that makes a difference to our members and our community every day!
A competitive compensation and benefits program
Excellent Retirement Savings program
A work-life balance