About Job
- Assess, plan, implement, monitor, and evaluate options and services to affect an appropriate, individualized plan with the beneficiary across the continuum of care
- Utilize clinical knowledge and competence, communication skills, problem-solving, and conflict resolution to ensure optimal beneficiary outcomes with consideration to client requirements effectively
- Develop beneficiary-centered care plans
- Demonstrate shared accountability between beneficiaries, caregivers, and providers
- Work collaboratively with the beneficiary, provider, and other Funds Health Care team members to coordinate care
- Address identified gaps in care or compliance
- Maintain strict standards for client confidentiality and client-related information
- Comply with all organizational, state, and federal regulations and policies on confidentiality
- Manage caseload to ensure all required documentation and entry of assessment results into the web-based database are completed accurately and timely, following regulatory requirements and company policies and procedures
- Maintain open communication with all appropriate parties
- Pursue ongoing education, certification, and self-development to remain current with case management standards
- Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
- Other duties as assigned
- Bachelor’s degree in social work
- Active, unrestricted social work license OR be a Qualified Mental Health Professional (QMHP)
- Minimum of 2 years of experience in Medicaid-funded case management, care coordination, or community health programs
- Minimum of 2 years of social work experience working with high-need populations (I/DD, aging adults, SMI, justice involved, rural communities, chronic disease, and other similar populations)
- Master of social work (MSW) or Case Management Certificate (CCM)
- Proficiency in using Microsoft Word, Excel, and other applications in the Microsoft Office suite
- Maintain a high level of confidentiality
- Ability to maintain metrics and goals within the department
- Assist members, and conduct outreach to members without prior engagement
- Strong understanding of cultural competency when working with the population
- Experience with commercial health plans
- Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making
- Demonstrated initiative and judgment in the performance of job responsibilities
- Ability to work independently and as part of a team
- Ability to research/identify and apply appropriate standards of care
- Interest in continuous learning and a commitment to staying informed on regulatory changes
Professional Field


Patient Focus
Diagnoses
Avoidant Personality Disorder
Gender Dysphoria
Issues
Aging
Age Groups
Preteens/Tweens (11-13)
Adults
Therapeutic Approach
Methodologies
ECT
Modalities
Individuals
Practice Specifics
Populations
Racial Justice Allied
Settings
Faith-based organizations
Private Practice
Research Facilities/Labs/Clinical Trials
State/Federal Government
Telehealth/Telemedicine
Home Health/In-home
Military
Forensic
Sign up for job alertsGet daily alerts for jobs relevant to you, sent to your inbox