Job Description – Licensed Clinical Social Worker (LCSW/LICSW)

Location - 725 North Street, Pittsfield, MA 01201

Additional Requirements:

• Current knowledge of CMS (levels of care determinations), appeal rights, and DPH regulations required
• Current knowledge of Kepro QIO (appeals) required
• Knowledge of regulatory and accreditation organizations such as Joint Commission, DPH, and HealthGrades preferred
• Proven organizational skills with the ability to analyze and present data
• Strong computer literacy and experience managing multiple open applications
• Ability to plan, implement, and evaluate change
• Data management skills preferred
• Excellent interpersonal and communication skills
• Ability to maintain confidentiality
• Strong collaboration and negotiation skills with providers, patients, families, insurance companies, and government agencies
• Ability to work independently and efficiently
• Demonstrated ability to build and maintain relationships with physicians
• Knowledge of local community resources required
• In-depth knowledge of Medicare, Medicaid, third-party commercial payers, and reimbursement processes required
• Skills in data comprehension, research, analysis, interpretation, and judgment necessary to prepare comprehensive summary reports for management, legal, or regulatory review

Submission Requirements:

• Education: Master’s Degree in Social Work (MSW) required
• Licensure:
• LCSW – Licensed Clinical Social Worker required
• LICSW – strongly preferred
• Experience:
• Minimum of 3 years of clinical experience in acute care (e.g., internal medicine, surgery, orthopedics, mother/child, cardiology, oncology, psychiatry)
• Additional 3+ years of experience in rehab settings, home health, or long-term care will be considered
• Demonstrated experience in:
• Utilization management (levels of care, evidence-based criteria tools)
• Comprehensive admission and discharge risk assessments (quality, financial, payer benefits, risk management, patient satisfaction)
• Discharge planning across the continuum of care
• Previous care management or third-party insurance review preferred

Certification Requirements:

• BLS – Basic Life Support (AHA)

State License Requirement:

• Massachusetts license required

Responsibilities

• Conduct comprehensive patient assessments to determine needs and develop appropriate care plans.
• Provide behavioral therapy and clinical counseling to individuals and families, utilizing techniques such as motivational interviewing and cognitive behavioral therapy.
• Manage medical documentation and ensure compliance with HIPAA regulations.
• Collaborate with healthcare teams for discharge planning and coordinate home health services.
• Maintain accurate medical records and utilize computer skills for data management.
• Support individuals with developmental disabilities and crisis intervention as needed.

Job Type: Contract

Pay: $70.00 - $75.00 per hour

Work Location: In person