The Social Worker is responsible to act as a liaison and assists in coordinating resources for the care of health plan members with multiple co-morbidities and/or psychosocial needs. The primary scope is to provide counseling and assistance to patients and their families as requested with personal, financial, ethical and environmental difficulties that predispose patients to illness. The Social Worker acts as an advocate for members and their families linking them to community resources and financial assistance programs for continued growth toward a maximum level of independence. The Social Worker will interact and collaborate with the interdisciplinary care team, which includes physicians, nurses, case managers, pharmacists, laboratory technologists, other social workers, dietitians and other educators.
If you are located in or near Louisville or Lexington, KY, you will have the flexibility to telecommute* as you take on some tough challenges.
Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements for Model of Care and Center for Medicare and Medicaid Services (CMS) regulations
Coordinates outpatient needs related to community resources, financial assistance programs, and long-term activity of daily living needs outside the benefit criteria of the medical insurance coverage
Attends member visits with their PCP and specialists as needed and provides related feedback on planned interventions and outcomes of plan of care
Identifies and assists with patients with high-risk diagnoses and/or patients with multiple co-morbidities who will benefit from social care coordination, contracts, providers, and facilities
Conducts site visits in the home, clinic, and hospital setting. Performs member evaluations in multiple settings, including but not limited to: member’s home, PCP/specialists clinic, hospital, and skilled nursing facility
Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations
Along with care team members, reviews the need for and assists with obtaining DME, home health and other resources necessary for the patient and educates them about their community resources and options and advocating on behalf of the patient
Takes ownership of the total work process and provides constructive information to minimize problems and increase internal and external customer satisfaction
Participates in the development of appropriate QI processes, establishing and monitoring indicators. Takes corrective action when data shows a need to modify management strategies or systems
Attends and contribute to staff meetings
Adheres to organizational and departmental policies and procedures
Seeks ways to improve job efficiency and makes suggestions to the appropriate manager
Performs all duties for internal and external customers in a professional and responsible manner
Performs all other related duties as assigned
The pace is fast and you’ll need to be comfortable managing multiple priorities. You may be required to work in multiple locations, so scheduling flexibility is essential. You must also be able to respond calmly and effectively in emergency situations
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Master’s degree in Social Work (LMSW)
- Current unrestricted KY social work license
- Three or more years social work experience in a health care environment
- Proficient in PC software computer skills such as Microsoft Word, Excel, Power Point, and other departmental specific programs/applications
- Ability and willingness to travel (locally and non-locally) as determined by business needs
- Reliable transportation that will enable you to travel to client and / or patient sites within a designated area
- Knowledge of disease management, managed care, medical terminology, referral process, claims, and ICD-9 and CPT coding
- Experience working with geriatric and psychiatric patient populations
- Experience working in managed care
- Bilingual (English/Spanish) language proficiency
- Prior field based work experience
- Experience working with Home Care Based Services
- Possess planning, organizing, conflict resolution, negotiating and interpersonal skills
- Independent problem identification/resolution and decision making skills
- Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously
Careers at UnitedHealthcare Community & State.
Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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