Social Worker, Social Services

Humana • Work at Home - Kentucky, SC

19h • $59,300 - $80,900 • Remote

About The Position

The Social Worker, Social Services works in a telephonic environment, assessing and evaluating members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Social Worker, Social Services work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Social Worker, Social Services employs a variety of strategies, approaches, and techniques to manage members' physical, environmental, and psychosocial health issues. You will identify and resolve barriers that hinder effective care and ensure patients are progressing toward desired outcomes through continuous monitoring, assessments, and evaluations. You may develop and maintain member care plans to support individual healthcare needs and goals. You will understand departmental, segment, and organizational strategies and operating objectives, including their connection to related areas. You will make decisions regarding your own work methods, occasionally in ambiguous situations, while requiring minimal direction and seeking guidance when needed. You will follow established guidelines, policies, and procedures to deliver effective and compliant care management services. Use your skills to make an impact.

Requirements

• Master's degree in social work from an accredited university.
• Current, unincumbered, social work license (LMSW, LCSW, or LICSW).
• Must have passed the ASWB Master's-Level exam.
• Minimum 3 years of experience working as a social worker in a medical healthcare setting (i.e. hospital setting, clinic).
• Proficient in Microsoft applications including Word, Outlook, Excel.
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Must be willing to obtain/maintain social work licensure in multiple states, based on business need.
• MUST have wired cable or DSL connection directly to a modem.
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Experience in a telephonic environment working with geriatric, vulnerable, and/or low-income populations.
• Experience and comfort using Epic EMR.
• Experience working with Medicare and Medicaid.
• Licensure in AL, FL, GA, KY, LA, MS, NC, OK, or SC
• Bilingual English/Spanish or English/Creole

Responsibilities

• Serve as a Licensed, Master's-level Social Worker within the Special Needs Plan (SNP) program, functioning as a Support Social Services associate and interdisciplinary care team member.
• Conduct telephonic outreach to members with social determinants of health (SDOH) needs to assess, support, and coordinate care using plan benefits and community resources.
• Utilize structured assessments to determine appropriate interventions, including care coordination, health education, resource connection, and advocacy.
• Collaborate with interdisciplinary team members (e.g., nurse care managers, dietitians, behavioral health, pharmacists), providers, and community partners to address member needs.
• Handle both outbound and inbound member interactions in a telephonic, work-from-home environment; perform follow-up as needed to ensure all needs are addressed.
• Assess members for additional support needs and initiate referrals to appropriate disciplines based on individualized circumstances.
• Develop, update, and maintain member care plans as needed to support ongoing care coordination.
• Document all interactions and care activities accurately in the member record to ensure CMS compliance and reflect engagement with members and care teams.

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• many other opportunities

What This Job Offers

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