Social Worker Specialist

Alivia Health

1d

About The Position

The Social Worker in the Specialty Pharmacy provides psychosocial support, care coordination, and patient advocacy for individuals with chronic and complex conditions. The Social Worker will not directly manage insurance plans, but the role requires a robust understanding of healthcare financial processes and Social Determinants of Health. This specialized knowledge is critical for effectively navigating and resolving patient barriers related to financial hardship, and equitable access to necessary and comprehensive care. The Social Worker coordinates referrals both within the pharmacy and with external providers to ensure comprehensive care.

Requirements

• Bachelor’s or Master’s degree in Social Work (BSW/MSW).
• State licensure (LSW, LMSW, LCSW, or equivalent).
• Experience supporting patients with chronic or complex health conditions.

Nice To Haves

• Experience in healthcare, specialty pharmacy, or case management.
• Familiarity with financial assistance programs, insurance appeals, and access-to-care resources.
• Strong interpersonal, organizational, and communication skills.
• Bilingual capability (a plus).

Responsibilities

• Conduct psychosocial assessments to identify social, emotional, financial, and environmental needs impacting treatment.
• Develop individualized care plans to address barriers to adherence and overall well-being.
• Provide emotional support, counseling, crisis intervention, and linkage to community resources.
• Serve as coordinator for internal patient referrals, from pharmacists, clinical support teams, nursing staff, and other pharmacy operation staff.
• Coordinate referrals outside the pharmacy to mental health providers, specialists, community agencies, transportation programs, and other social services
• Follow up on referrals to ensure patients receive the intended services and support.
• Assist patients in understanding financial challenges related to treatment costs and available support options
• Provide guidance on accessing financial assistance programs, charity resources, and community-based aid
• Support patients through insurance barriers by: 1. Educating them on the appeal or reconsideration process. 2. Helping them gather necessary documentation 3. Collaborating with pharmacy benefits teams or case managers responsible for     insurance processing. 4. Advocate on behalf of patients to ensure equitable access to medication and treatment.
• Educate patients and caregivers about treatment expectations, support programs, and community resources
• Advocate internally and externally to help resolve barriers to care and improve patient experiences.
• Maintain accurate and timely documentation of assessments, interventions, referrals, and follow-ups.
• Comply with HIPAA standards and all organizational guidelines.
• Participate in quality improvement initiatives related to patient outcomes and service delivery.

What This Job Offers

• Job Type: Full-time
• Number of Employees: 251-500 employees