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 identifies and refers members to community resources, counseling, and support services; provides education about entitlement programs, legal issues, and other services relevant to social work practice; and partners with members and community organizations to develop and implement plans of care. Using the case management process, the Social Worker assesses, develops, implements, monitors, and evaluates care plans across the care continuum. The role coordinates behavioral health and other services, manages behavioral and psychosocial needs, arranges resources, documents activities, and evaluates members’ ability to manage independently and locate resources. The Social Worker also supports members and authorized representatives with entitlement applications, long-term care and end-of-life planning, and hospice-related needs. The position participates in multidisciplinary conferences, follows professional standards and quality and production goals, and continues professional development, including maintaining Certified Case Manager (CCM) certification.

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 affecting member outcomes.
Knowledge of HIPAA regulations and guidelines, the Americans with Disabilities Act, and clinical ethics.
Knowledge of BCBSM/BCN benefits.
Ability to engage and motivate members or their representatives, mentor, and train.
Ability to identify existing or potential psychosocial and quality-of-care issues.
Empathetic, supportive, and a good listener.
Proficiency in motivational interviewing skills.
Demonstrated time-management and organizational skills, including managing 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.
Excellent written and verbal interpersonal and communication skills.

Nice To Haves

Home health care and/or medical case management experience.
At least 2 years of experience in home health care and/or medical case management.
Experience managing patients by telephone and through digital channels, including mobile applications and messaging.
Certified Case Manager (CCM) certification, or ability to obtain it within 18 months of hire.

Responsibilities

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