This position is located in the Dallas office with potential to work from home once training is completed and satisfactory performance is maintained.
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.
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.
- 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
- Assists in the growth and development of self and associates by sharing special knowledge with others
- Attends educational offerings to keep abreast of change and comply with licensing requirements
- Maintains knowledge of the Health Plan Benefits
- Performs all other related duties as assigned
This position is based out of our Dallas office and has a potential to work from home once training / orientation is completed and strong performance is maintained.
- Master’s degree in Social Work (LMSW)
- Active SW license in the applicable state
- 3+ years of social work experience in a health care environment
- Possess planning, organizing, conflict resolution, negotiating and interpersonal skills
- Proficient in PC software computer skills such as Microsoft Word, Excel, Power Point, and other departmental specific programs / applications
- Independent problem identification / resolution and decision making skills
- Must be able to prioritize, plan, and handle multiple tasks / demands simultaneously
- Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
- This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease
- 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
- Bilingual (English/Spanish) language proficiency
Careers with WellMed
Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.