Social Work Case Manager

Baystate Health•Springfield, MA

11h•$66,081 - $89,876•Remote

About The Position

Social Work Case Manager (LCSW, LICSW or LMHC) Baystate Health/Health New England Services, a nationally recognized leader in healthcare quality and safety and is looking for a Social Work Case Manager to join our team. Resume required with application. The Social Work Case Manager collaborates with the Behavioral Health Manager, Nurse Case Manager, Care Coordinators, Behavioral Health Care Managers, and medical health clinicians to deliver social work case management services to members in compliance with current accreditation requirements and quality standards, and within the scope of the members’ benefit package and per HNE policies. Arrange, coordinate and advocate for services to meet the psychosocial needs of the member and if indicated, the family and caregivers of the member. Supports the HNE mission by developing partnerships with and providing personal and accountable service to members and providers. Impact positive health outcomes for members and positive financial outcomes for HNE. Keep abreast of professional standards, new technologies and proactively seek out new learning. Available to cover weekends, evening hours and Holidays as needed to ensure organizational compliance with requirements from NCQA, DOI or employer group contracts. Also will provide minimum UM support as needed.

Requirements

Master’s degree in Social Work, Psychology, Education, Public Health or a related field
Minimum of three years of experience working with individuals with complex medical, behavioral and psychosocial needs.
Current state licensure as a social worker or related field
Experience in patient education working with individual patients
Knowledge of chronic health conditions preferred
Must be self-starter willing to proactively seek out and learn about etiology, care and treatment for many health conditions
Excellent verbal and written communication skills in both English and Spanish preferred
Computer literacy and ability to navigate through computer systems
Skilled at deliver presentations
Sound assessment and decision-making skills, and highly ethical
Excellent critical thinking and organizational skills, with attention to detail
Excellent time management skills and ability to manage multiple priorities
Strong teamwork skills; ability to work collaboratively and consultatively with team members
Ability to work independently and manage an assigned caseload
Must live in MA or CT for commutable requirements

Nice To Haves

Knowledge of chronic health conditions
Excellent verbal and written communication skills in both English and Spanish
Excellent time management skills and ability to manage multiple priorities

Responsibilities

Collaborates with the Behavioral Health Manager, Nurse Case Manager, Care Coordinators, Behavioral Health Care Managers, and medical health clinicians to deliver social work case management services to members in compliance with current accreditation requirements and quality standards, and within the scope of the members’ benefit package and per HNE policies.
Arranges, coordinates and advocates for services to meet the psychosocial needs of the member and if indicated, the family and caregivers of the member.
Supports the HNE mission by developing partnerships with and providing personal and accountable service to members and providers.
Impacts positive health outcomes for members and positive financial outcomes for HNE.
Keeps abreast of professional standards, new technologies and proactively seeks out new learning.
Available to cover weekends, evening hours and Holidays as needed to ensure organizational compliance with requirements from NCQA, DOI or employer group contracts.
Provides minimum UM support as needed.
Outreaches to assess member’s social, emotional, environmental, financial and support needs which are impacting health outcomes.
Provides or arranges for resources necessary to meet members’ psychosocial needs.
Effectively utilizes methods and models of social work intervention to engage members in care management.
Provides ongoing health coaching and support, self-management education, condition-specific education, care coordination, and resources and materials.
Assists members when necessary, in placing calls, completing applications, and advocating for available supports/services.
Assists members and providers with transition of care, referral management, care coordination, and benefit management.
Links members to appropriate community resources for health and health-related services consistent with regulatory, contractual, and corporate requirements.
Researches and shares community resources with members and the case management team.
Promotes and encourages member collaboration with the primary care provider, other health care providers and social service agencies.
Facilitates interdisciplinary consultation on members’ behalf through participation in rounds, team meetings and clinical reviews.
Conducts face-to-face visits with selected members as appropriate.
Completes documentation in the medical management information system in a timely manner and in keeping with internal policy and accreditation standards.
Conducts assessments via phone and develops a service plan which outlines clear goals, time frames and responsibilities.
Adheres to departmentally established productivity standards.
Maintains HIPAA standards and confidentiality of protected health information.
Adheres to departmental/organizational policies and procedures.
Understands the concepts, features, benefits, disclosures and provisions of government health insurance programs.
Works collaboratively and cohesively with all members of the CSI Team in order to coordinate a continuum of care for members consistent with the members’ health care goals and needs.
Facilitates member communication with internal partners such Member Services.
Provides support for BH UM responsibilities as needed.

Benefits

Excellent Compensation
High-quality, low-cost medical, dental and vision insurance
Generous PTO – up to 25 days in the first year, with scheduled earned increases
Continuing education support and reimbursement
First Time Home Buyers Financial Packages
Farm Share Memberships
403b retirement company match & annual company contribution increase based on years of service
Free money coach advice from a certified professional
Wellbeing programs that include but are not limited to mental, physical, and financial health
Adoption assistance
Pet, home, auto and personal insurance
Life insurance
Work-life integration
Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!