Social Care Screener

Vanderheyden, Inc.•City of Troy, NY

4d•Hybrid

About The Position

The Social Care Screener engages Medicaid members in person, telephonically, or virtually to discuss screening, complete screening, and determine eligibility to address health-related social needs using a person-centered, culturally responsive, and trauma-informed approach. This role confirms eligibility for services by utilizing Epaces to ensure insurance is active and billable. The screener coordinates screening and eligibility assessment with individuals and documents the status of completion to meet health-related social needs, including but not limited to housing instability, food insecurity, transportation barriers, utility needs, and interpersonal safety. Ensuring all documentation supports service verification, encounter reporting, utilization review, and audit validation is crucial. The position involves completing NY1115 - AHC Screening and Eligibility Assessment, and if eligible, opening a Social Service Case Management, referring to a Social Care Navigator, and creating a service note for billing. The screener works closely with the Social Care Navigator and Assistant Director regarding referral status, service plans, and billing. Collaboration with care managers, peer advocates, and clinical teams is expected to support integrated care planning and continuity of care. The role requires monitoring and tracking weekly numbers of individuals receiving SDOH Care Screening services and SDOH Case Management services. Participation in quality assurance, data validation, and utilization monitoring activities related to 1115 Waiver reporting is also a key function. The screener will support internal reviews, corrective action plans, and external monitoring or audit requests. Maintaining confidentiality and complying with HIPAA, Medicaid, and DOH data privacy and security requirements is mandatory. Attendance at required training related to DOH guidance, waiver updates, reporting requirements, and program compliance is necessary. Participation in supervision, team meetings, and case conferences is required. The role may involve performing other duties as assigned in support of DOH and 1115 Waiver program objectives. Meeting weekly billables is essential for program viability, with a target of 5 screenings and assessments daily.

Requirements

Associate’s degree in human services, public health, social work, or related field
Experience in case coordination, care navigation, outreach, or direct service provision with Medicaid or underserved populations.
Knowledge of SDOH/HRSN concepts and community-based service systems.
Ability to follow standardized protocols for screening, assessing, referring, documentation, and follow-up.
Demonstrated ability to maintain accurate, timely, and compliant records.
Proficiency with electronic health records and/or DOH-aligned reporting systems.
Strong organizational, communication, and interpersonal skills.

Nice To Haves

Bachelor's degree preferred.
Experience with NYS DOH programs, Health Homes, Managed Care, PPS initiatives, or 1115 Waiver services.
Familiarity with DOH guidance, Medicaid documentation standards, and audit processes.
Experience using referral tracking platforms or community resource databases.
Bilingual or multilingual proficiency.

Responsibilities

Engage Medicaid members in person, telephonically, or virtually to discuss screening, complete screening and determine eligibility to address health-related social needs using a person-centered, culturally responsive, and trauma-informed approach.
Confirm eligibility for services, utilizing Epaces to ensure insurance is active and billable.
Coordinate screening and eligibility assessment with the individuals and document status of completion to meet health-related social needs, including but not limited to housing instability, food insecurity, transportation barriers, utility needs, and interpersonal safety.
Ensure all documentation supports service verification, encounter reporting, utilization review, and audit validation.
Complete NY1115 - AHC Screening.
Complete Eligibility Assessment, confirm eligibility. If eligible, open Social Service Case Management refer to Social Care Navigator and create service note for work completed for billing.
Work closely with Social Care Navigator and Assistant Director regarding status of referrals, service plans, billing, etc.
Collaborate with care managers, peer advocates, and clinical teams to support integrated care planning and continuity of care.
Monitor and track weekly number of individuals receiving SDOH Care Screening services and SDOH Case Management services (name of individual, date of screening, date of assessment, level: 1 or 2, etc.).
Participate in quality assurance, data validation, and utilization monitoring activities related to 1115 Waiver reporting.
Support internal reviews, corrective action plans, and external monitoring or audit requests assigned.
Maintain confidentiality and comply with HIPAA, Medicaid, and DOH data privacy and security requirements.
Attend required training related to DOH guidance, waiver updates, reporting requirements, and program compliance.
Participate in supervision, team meetings, and case conferences as required.
Perform other duties as assigned in support of DOH and 1115 Waiver program objectives.
Meet billables weekly to ensure viability of program (5 screenings and assessments daily).