Community Social Worker (Remote)

Florida Blue • FL, FL

13h • $65,400 - $106,200 • Remote

About The Position

The Community Social Worker (CSW) will work in coordination with the Care Team and other stakeholders by utilizing targeted member outreach to identify and address member's social determinates of health and need for community resources. The CSW will engage/consult members and complete appropriated social work assessment(s) to determine the nature of a member's situation by conducting telephonic/virtual interviews to assess and determine member's medical, psychological, emotional, financial, and social status. The CSW will be responsible for identifying barriers to the members care plan. This role will also be required to assist members with exploring community resources and referring members to appropriate community resources. Assists members manage their daily lives, understand and make difficult health care choices and obtain social services, such as health care and government assistance.

Requirements

• 3+ years related work experience in Healthcare Industry and Managed Care, assisting with discharge planning, linking to community resources, navigation of financial assistance programs, chronic illness resources, etc.
• Related bachelor's degree required Minimum bachelor's degree in social work, sociology or psychology or addition related equivalent work experience.
• Extensive knowledge of community resources (local, statewide, national, and international)
• Experience with the Healthcare industry and Managed Care
• Demonstrated knowledge in Social Work care management
• Non-traditional working hours to meet the member's availability and business objectives
• Intermediate to Advanced PC skills, experience and/or knowledge of digital engagement tools a plus

Nice To Haves

• Master’s degree Social Work or related
• Bi-lingual (Spanish, or Creole, or French)

Responsibilities

• Operates as a member advocate utilizing skills that respect issues of cultural considerations for every patient and family.
• The CSW and activities is a key contributor to the member Engagement annual target and ROI value.
• The CSW will maintain and manage their own member caseload for members received from a daily worklist and serve as a consultant for referrals sent from numerous sources on cases managed by other Care Team members.
• Determine member's discharge status and identify and coordinate any additional needs and services that require ongoing Care Coordination services and resources (i.e., targeted emergency department frequent utilizers).
• The CSW will use a standardized, evidence based social need/SDoH assessment tool to evaluate and identify member needs (psychosocial status, financial, and physical needs of members; assess patient’s support systems, available community resources and other factors to plan, develop, and implement an appropriate plan of care.
• Identifies and screens high risk members that would benefit from coordination of community health related services, behavioral change counseling and refer members to appropriate care programs and other members of the care team (RN Care Managers, Registered Dieticians, LCSW (behavioral health) and Pharmacists).
• Assess member’s end of life planning and provide appropriate resources and referrals.
• Coordinate care for members as appropriate based on care/treatment plan and benefit limitations.
• Educate members and assist with formulating strategies/goals to help prevent disease, disability and or pre-mature death.
• This position will also be responsible to vet the tools and resources most commonly used by the discipline to ensure accuracy, relevance and appropriateness also maintains the internal community resource site.
• Serve as members’ point of contact as needed to provide education regarding benefits, network, network access and community and government agencies that are available to assist members when benefits are not available or exhausted.
• Evaluate, reports, and participates in effectiveness of discharge planning activities, patient care conferences and referrals to appropriate behavioral and community resources.
• Collaborates with internal and external partners to remove barriers access and or Care Management staff to address the care and social service needs of members through member engagement.
• Provide consultation to RN care managers, dieticians, pharmacists and LCSWs (behavioral health).
• Collaborate and provide consultation support to external stakeholders (hospital d/c planners, SNF/rehab facility staff, care partners and vendors).
• Identify and implement continuous improvement opportunities.
• Miscellaneous project assigned by Manager (adhoc reports, projects, etc.).

Benefits

• Medical, dental, vision, life and global travel health insurance
• Income protection benefits: life insurance, short- and long-term disability programs
• Leave programs to support personal circumstances
• Retirement Savings Plan including employer match
• Paid time off, volunteer time off, 10 holidays and 2 well-being days
• Additional voluntary benefits available
• A comprehensive wellness program
• Competitive pay
• Opportunities for incentive or commission compensation
• Regular annual reviews with pay for performance considerations for base pay increases

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level