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Social Worker Care Manager

Network Health is seeking a Social Work Care Manager for our special needs plan team. This individual provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The care manager advocates for and supports member care management needs by providing professional social work services and care management while coordinating benefits and resources. 

Job Responsibilities:

Screens candidates for management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines.
Updates care plan to reflect progress towards goals; closes cases when expected goals/outcomes are achieved.
Provides information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
Evaluates and processes member referrals from physicians to other specialty providers
Assess, plans, facilitates and advocates for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
Works with members and families on self-management approaches using coaching techniques such as motivational interviewing
Educates the individual, his/her family and caretakers about case and condition management, the individual’s health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes.
Facilitates the coordination, communication and collaboration of the individual’s care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality.
Schedules visits with the individual and participates in facility based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning.
Stays abreast of current best practices and new developments
Other duties as assigned 

Job Requirements:

Bachelors Degree in Social Work, or related field.
Four years work experience as a Social Worker or Case Manager.
Prior experience with Medicare or Managed Care preferred.
Experience working in behavioral health preferred.
Current licensure in the State of Wisconsin as a Certified Social Worker, or eligible to hold certification within 120 days of hire.
CAPSW, CISW preferred. 

Time:  Full time
Salary:  Hourly
Category:  Clinical/pharmacy/quality

Updated: 7/25/2022 12:33:00 PM