Job Details

Job Location
Main Office - Santa Barbara, CA

Position Type
Full Time

Education Level
Master's Degree

Job Category
Medical Management

Description

Central Coast Annual Salary Range: $76,466 - $110,875 Annually

Candidates for this position must reside on the Central Coast (Ventura, Santa Barbara, San Luis Obispo, Monterey, and Santa Cruz Counties) or be willing to relocate to the area upon hire. As a community-facing role, a local presence is essential to effectively engage with and serve our community. Please note that relocation assistance may be available.

Job Summary

This position is responsible for collaborating closely with the Health Services team and working directly with members to support their psychological and social care coordination needs. The Master's-prepared CM Social Worker addresses both the psychosocial needs of members and their access to government programs, social services, and community resources. Key responsibilities include, but are not limited to, communicating with members, providers, and community-based organizations; assisting pediatric members with special healthcare needs and their families in transitioning to adulthood; providing housing resource support; referring to funding sources; identifying community resources to help members remain in the least restrictive environment; and acting as a liaison between the Health Services Pediatric team and California Children's Services (CCS) Medical Therapy Program staff.

Duties and Responsibilities

•Conduct member-centered assessments and reassessments, addressing psychosocial, rehabilitation, and environmental concerns.
•Based on assessment findings, coordinate, arrange, and monitor services from various providers to meet member needs.
•Follow up with members, monitor their needs and care plans, and develop support systems as necessary.
•Assist CCS members and their families with transition care planning from age 16 to 21, when members age out of CCS.
•Assess the member as a whole, identifying functional limitations that affect independent living.
•Provide resources and linkages for crisis management support.
•Develop individualized, member-centered care plans.
•Consult with the Medical Director or Nurse Care Manager on medical issues as needed.
•Refer members to specialized programs such as Tri County Regional Center (TCRC), County Behavioral Wellness, Public Health, and Family Service Agency (FSA).
•Collaborate with community organizations to facilitate linkage, referral, advocacy, and follow-up to achieve care plan goals.
•Recommend strategies to improve the member's functional capabilities.
•Maintain an active caseload, providing interventions within your area of expertise and scope.
•Adhere to high ethical standards and comply with HIPAA and confidentiality regulations.
•Participate in ongoing education to stay informed in areas of expertise.
•Attend CCS Medical Therapy Unit Conferences to address psychosocial issues of members and their families.
•Perform other duties as assigned.

Qualifications

Skills/Knowledge/Abilities

Required:

•Proven expertise and experience as a care manager.
•Ability to communicate clearly and effectively with members, families, physicians, and other healthcare providers.
•Self-motivated to seek knowledge and continuously improve personal and professional performance.
•Ability to work collaboratively in a cross-functional team environment.
•Strong computer literacy and proficiency in using various software applications.
•Excellent verbal and written communication skills.
•Knowledge of community resources and the ability to connect members with appropriate agencies.

Preferred:

•Understanding of managed care issues, including benefits, contract limitations, delivery, and reimbursement systems, as well as the role of medical management activities.
•Familiarity with State and local social service agencies and community-based organizations.
•Current certification in crisis prevention and intervention.
•Commission for Case Manager Certification (CCMC).
•Knowledge and experience in community-based behavioral health care resources.
•Understanding of the unique medical and psychosocial challenges faced by children and young adults with disabilities and special healthcare needs.
•Bilingual in Spanish.

Education and Experience

Required

•A Master's degree in Social Work, Clinical Psychology, Psychology, or a related field is required. A concentration in Gerontology, Pediatrics, Public Health, Substance Abuse, Mental Health, or other related areas is preferred.
•A minimum of three (3) years of clinical work experience in the specified field is required.
•A Licensed Clinical Social Worker (LCSW) license can substitute for two years of work experience.
•Experience providing services and addressing the needs of children and young adults with disabilities and special healthcare needs is required.
•At least one (1) year of experience in a managed care or health plan setting, with experience in Medi-Cal or Medicaid preferred.
•A minimum of one (1) year of experience in case management and care coordination is preferred.
•Experience in developing individualized, member-centered care plans is required.