Social Worker (Medical)

Blue Cross Blue Shield of Michigan•Detroit, MI

About The Position

The Social Worker supports improvement of members’ health status in collaboration with case managers and physicians. The role assesses psychosocial needs, identifies and coordinates community and behavioral health resources, and works with members and community partners to develop and implement plans of care. Using the case management process, the Social Worker assesses, develops, implements, monitors, and evaluates care plans to optimize members’ health across the care continuum. The Social Worker consults with case managers and physicians to identify member issues and determine appropriate interventions. The role provides social work interventions for behavioral and psychosocial needs; assists with resource coordination, entitlement applications, long-term care planning, and end-of-life decisions; and supports members receiving hospice services. The Social Worker documents activities, evaluates members’ ability to manage their care and locate resources, participates in multidisciplinary team conferences, and follows professional protocols, quality standards, and production goals. Continuing professional development and maintaining Certified Case Manager (CCM) certification are expected.

Requirements

Master’s degree in Social Work or Psychology.
At least 3 years of practice as a Licensed Master’s Social Worker.
Current unrestricted Licensed Master’s Social Worker license in Michigan.
Ability to think critically, make decisions, and solve problems that may affect member outcomes.
Knowledge of HIPAA regulations and guidelines, the Americans with Disabilities Act, and clinical ethics.
Ability to engage and motivate members or their representatives, and to mentor and train.
Ability to identify existing or potential psychosocial and quality-of-care issues.
Empathy, supportiveness, and strong listening skills.
Proficiency in motivational interviewing.
Demonstrated time-management and organizational skills, including the ability to manage multiple systems and tools while interacting with members.
Intermediate computer knowledge, typing capability, and proficiency with Microsoft programs such as Excel, OneNote, Outlook, Teams, and Word.
Ability to work as part of a team and independently.
Ability to collaborate with a multidisciplinary team while advocating on members’ behalf.
Excellent written and verbal interpersonal and communication skills.

Nice To Haves

At least two years of home health care and/or medical case management experience.
Experience managing patients telephonically and through digital channels, including mobile applications and messaging.
Certified Case Manager (CCM) certification; certification may be obtained within 18 months of hire.
Knowledge of BCBSM/BCN benefits.

Responsibilities

Collaborate with case managers and physicians to identify member needs and develop plans to address them.
Use the case management process to assess, develop, implement, monitor, and evaluate member care plans.
Identify, refer members to, arrange, and coordinate government, community, employer, behavioral health, mental health, substance abuse, financial support, and disease-specific resources.
Manage behavioral and psychosocial needs and provide social work interventions.
Assess member progress through on-site visits and POD review sessions when invited.
Assist case managers with psychosocial needs assessments and resource identification.
Document activities, including member assessments, communications with case managers and primary care physicians, and issues involving guardianship or abuse/neglect.
Evaluate members’ ability to independently manage their care and locate resources.
Educate members or authorized representatives about entitlement programs and legal issues, and assist with applications as needed.
Assist with long-term care planning and end-of-life decisions and options.
Support members during hospice care and provide information about appropriate community resources.
Participate in multidisciplinary team conferences.
Follow professional standards, protocols, rules, and guidelines while meeting quality and production goals.
Complete relevant continuing education and maintain Certified Case Manager (CCM) certification.