Care Coordination Social Worker D-SNP

This is a Defined Term position, which is designated by the Alliance and is a position of limited duration. Defined Term employees are usually hired to work in a specific department on specific long-term project work until the work is completed or to a specific end date not to exceed December 31, 2026. This is a Defined Term and fully benefited position.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Medicare Care Management Manager (RN), this position:

• Develops and manages an individualized intervention plan for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred into the Care Coordination program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner
• Works in conjunction with the interdisciplinary Care Coordination team to facilitate quality outcomes across the continuum by educating members, caregivers, providers, external agencies, and internal teams and providing assistance in navigating the managed care system
• Participates in program evaluation and quality improvement efforts to ensure D-SNP program effectiveness and compliance with regulatory requirements

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here. 

• Knowledge of:
• The principles and practices of case management and coordination, including assessment, care/treatment planning, discharge planning. and documentation
• The availability and means of utilizing community resources for special services
• Reporting methods for cases of abuse or neglect
• Community resources and behavioral health systems
• The needs of older adults, individuals with disabilities, and/or those with complex medical or psychosocial needs
• Ability to:
  • Effectively interview members to determine their strengths, problems prognosis, functional status, goals, and need for specific services and resources, and to establish short-term and long-term goals
  • Assess psychosocial needs and conduct culturally competent interviews
  • Use proactive customer services skills in responding to complex and demanding situations
  • Advocate on behalf of the individual member to assure quality of care and attainment of appropriate goals
• Education and Experience:
  • Possession and continued maintenance, in good standing, of a Licensed Clinical Social Worker (LCSW) license issued by the State of California
  • Master’s Degree in Social Work or related field and two years of social service experience in an acute care, community-based, or managed care environment which included developing and managing member-centered care plans; or an equivalent combination of education and work experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).