Caseworker Jobs

About The Position

Requirements

• Bachelor's Degree in a related field (e.g., social work, health science, psychology, sociology, early childhood education).
• 2 years of proven professional experience working directly with SMI members (Serious Mental Illnesses) aged six and up who may have Psychotic Disorders, Bipolar Disorders, or Major Depression.
• 2 years of social services experience, engaging with clients (individuals, families, communities), assessing their needs, connecting them to services, and monitoring their progress.
• Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record and documentation programs.
• Proficiency with Electronic Case Management Platforms (e.g., Jiva).
• Strong documentation and record-keeping skills, emphasizing accuracy and adherence to established methods.
• Proven professional expertise in assessing members' situations, developing care plans, and teaching self-management.
• Skilled in working one-on-one with members, effectively communicating preventative health and management philosophies.
• Skilled in presenting health education materials to both individuals and small groups.
• Valid driver's license.
• Reliable transportation.
• Auto insurance.

Nice To Haves

• Master's prepared

Responsibilities

• Managing and coordinating care, services, and social determinants of health for Members with behavioral health conditions and acute, chronic, and medically complex needs.
• Serving as the primary point of contact for the care team, including Members, physicians, and community supports.
• Guiding members in achieving their optimal level of health.
• Identifying issues, gaps in care, and barriers to care using assessment and communication skills, critical thinking, and clinical knowledge.
• Developing a plan of care through shared decision-making with the Member/caregiver and in collaboration with providers and other care team members.
• Supporting Members during transitions of care through assessment, coordination of care, education of the discharge plan of care, referrals, and evaluation of the plan's effectiveness.
• Reviewing medication lists and coordinating pharmacy needs with community pharmacists.
• Evaluating, monitoring, and updating the care plan through regularly scheduled follow-up contacts.
• Establishing points of contact to collaborate with identified community, medical, and/or behavioral health teams.
• Maintaining timely, complete, and accurate documentation of Member interactions in ACFC electronic care management platforms.
• Monitoring appropriate utilization and coordinating services with other payer sources.
• Making appropriate referrals and identifying and escalating quality of care issues.
• Developing a working knowledge of ACFC electronic care management platforms, care management programs, policies, standard operating procedures, workflows, Member insurance products and benefits, community resources and programs, and applicable regulatory, state, and NCQA requirements.
• Identifying cases to be presented at care management rounds and following up with providers on recommendations.
• Supporting a positive workplace environment, collaborating, and sharing clinical knowledge and skills.
• Conducting Face-to-face visits at the Member’s residence, provider’s office, hospitals, other acute locations, or community locations for education and/or assessment.

Benefits

• Flexible work solutions including remote options
• Hybrid work schedules
• Competitive pay
• Paid time off including holidays and volunteer events
• Health insurance coverage for you and your dependents on Day 1
• 401(k)
• Tuition reimbursement