Social Worker, CareCoach Connect at Cameron County

UnitedHealth Group•Harlingen, TX

16d•$49,700 - $88,800•Hybrid

About The Position

The Social Worker is responsible for the assessment, planning, coordination and oversight of services for identified patients’ within their respective healthcare plan. The position identifies, evaluates, and provides management of services for patients with complex, catastrophic, SDOH (Social Determinants of Health) and/or psychosocial issues to promote quality, effective outcomes throughout the care continuum. The position ensures compliance with state and federal health plan requirements, Medicare guidelines and standards. Acts as a liaison to coordinate and collaborate care with physicians, family, and other providers while always remaining an advocate for patients, putting them at the center of care delivery. The Social Worker will interact and engage with others as an interdisciplinary team member.

Requirements

Bachelor of Social Work with a minimum of 3 years’ experience beyond the required years of experience
Current BLS certification or must obtain certification within 30 days of employment hire date
3+ years social work experience in a health care environment
Proficient in MS Office Suite to include Word, Excel, Notes, Outlook, and other departmental specific programs/applications
Reliable transportation for daily travel to various locations as assigned
Have a valid drivers license within the state of work

Nice To Haves

Masters of Social Work with licensure (LMSW or LCSW or LBSW)
Knowledge of disease management, managed care, medical terminology, referral process, claims, and CPT coding
Experience working with geriatric and behavioral and mental health patient populations
Long Term Care experience
Bilingual (English/Spanish) language proficiency
Able to prioritize, plan, and handle multiple tasks/demands simultaneously
Excellent oral and written communications skills
Solid organizational skills

Responsibilities

Perform comprehensive evaluations and document findings in a concise/comprehensive manner that is compliant with documentation standards for the Center for Medicare and Medicaid Services (CMS)
Performs patient assessments in multiple settings to include but not limited to the patient’s home, the PCP/specialists clinic, hospital, and/or skilled nursing facility as needed
Understands and plans to assure services provided work within the boundaries of the patient’s plan eligibility. Coordinates identified patient’s needs utilizing federal, state, and local community resources, as available
Coordinates with external and internal teams to minimize obstacles and increase in patient and provider satisfaction
Active participation in Performance Improvement (PI) or regional strategic initiatives
Active participation in staff and Interdisciplinary Teams (IDT) meetings
Adheres to organizational and departmental policies and procedures
Maintains a high level of professionalism and adheres to the WellMed Core Values
Assumes responsibility for personal and professional development
Ensures licensure, certifications, and annual training are maintained and compliant
Maintains knowledge of current health plan benefits
Performs other duties as assigned