Social Worker - CCBD

Versiti, Inc.•Wauwatosa, WI

2d•Hybrid

About The Position

Under the direction of the Medical Director and Manager of Versiti's Comprehensive Center for Bleeding Disorders (CCBD), and as a member of the comprehensive care team, the Social Worker has two primary areas of practice: psychosocial assessment /support and financial/insurance counseling. The CCBD Social Workers are expected to maintain competency in both areas, but may have a day to day focus in one area or the other and act as back up for each other.

Requirements

Master's Degree in Social Work, Counseling, Human Services or related degree required
4-6 years Master's degree level experience required, providing psychosocial services, mental health and/ or family counseling, with strong preference for clinical or hospital setting required
4-6 years Vocational/educational counseling to include collaborating with school officials and employers to help coordinate patient care required
Excellent written, oral, and interpersonal communication skills required
Excellent organizational and prioritization ability with attention to detail required
Ability to work independently under minimum supervision as well as to function as a productive team member required
Ability to assess psychosocial functioning of families and patients required
Proficient in computer applications necessary for position, including Microsoft Office and electronic databases and medical records required
Valid Wisconsin driver’s license and access to a vehicle required
Licensed Clinical Social Worker (LCSW) OR Certified Social Worker (CSW) required

Nice To Haves

4-6 years Experience with public and private insurance counseling, obtaining prior authorizations for laboratory and medical tests, as well as medications preferred

Responsibilities

Gathers and assesses data pertinent to psychosocial functioning of patients and families, including: education, vocation, lifestyle, interpersonal relationships, major life changes, coping techniques and abilities, and the psychosocial impact of living with a bleeding disorder or clotting disorder.
Provides supportive counseling and education to patients, families, and caregivers in the clinic or hospital, in the patient’s home and by phone.
Provides community referrals, assisting with appointment scheduling and transportation needs.
Within the parameters of patient confidentiality, records, maintains, and shares information pertinent to the treatment of the patient and family caregivers with other members of the treatment team.
Collaborates with the CCBD care team to develop and provide basic education programs regarding bleeding disorders and prevention of complications for schools, community organizations and patients’ extended families.
Establishes and maintains contacts within the bleeding disorders support community, including other treatment centers and hemophilia foundations. Act as a resource for support groups, retreats, seminars and educational programs.
Provides sound financial and insurance counseling to all CCBD patients and patient families, with bleeding and clotting disorders. Counseling is provided in the clinic setting, by phone, in the home or any other setting as necessary.
Maintains ongoing, frequent contact with CCBD patients/families to proactively identify potential upcoming life changes that could impact financial and insurance status, such as transitioning to adulthood, divorce, job changes, etc.; takes appropriate action to circumvent negative financial consequences and assure uninterrupted coverage.
Collects and continuously updates all insurance information on patients including primary and secondary insurance and co-pays, deductibles and OOP (out-of-pocket) limits, in-network providers, etc.
In collaboration with the Pharmacy team, procures all necessary and timely insurance verification and prior authorizations for factor products and other medications as well as medical treatment related to bleeding and clotting disorders.
Troubleshoots insurance issues; follows through with clear communication to ensure outcomes to insurance issues that are satisfactory to both the patient and the provider.
Assists the CCBD staff in providing documentation for insurance and Medicaid/Medicare denials, including for clotting and mild bleeding disorder patients.
Ensures that all home care patients are enrolled, when eligible, in contingency insurance coverage for factor product as well as medical care (e.g. WCDP—Wisconsin Chronic Disease Program, PSI—Patient Services, Inc., COBRA—Consolidated Omnibus Budget Reconciliation Act, manufacturer’s Patient Assistance Programs, free trial offer programs and other insurance type programs, etc.); helps patients maintain their eligibility for these programs; maintains a list of multiple financial and programmatic resources for CCBD patients.
Functions as part of a comprehensive team, provides cross coverage for other team members, and provides assistance with process development, implementation of new programs and other initiatives, and other projects/duties as assigned; works very closely with BloodCenter’s Pharmacy staff to insure that CCBD patients have the necessary resources to access medical care and treatment.
Actively participates in continuous improvement and quality improvement initiatives.
Collaborates with Great Lakes Hemophilia Foundation (GLHF) for Patient Financial Assistance (PFA) referrals, advocacy, development of resources and other patient issues.
Assists in maintaining patient files / medical records and/or patient or pharmacy databases.
Participates in professional activities to keep current on social work/insurance trends and regulations, including maintaining licensure.
Performs other duties as required or assigned which are reasonably within the scope of the duties in this job classification.
Understands and performs in accordance with all applicable regulatory and compliance requirements.
Complies with all standard operating policies and procedures.