About Job
We are seeking a Licensed Master Social Worker to ensure the promotion of health and wellness of HIV-positive, homeless, and transgender members through the development and oversight of an evidence-informed, individualized Plan of Care that addresses their complex medical, behavioral health, and social service needs. This position may be deployed, based on business needs, to healthcare facilities throughout New York City to provide case management services.
Scope of Role & Responsibilities:
- Provides telephonic and/or face-to-face care management services to members at designated HIV primary care facilities, including care coordination, transition of care, outpatient follow-up, and ancillary service review to ensure optimal health outcomes.
- Develops and implements an individualized member Plan of Care utilizing various resources, including, but not limited to member, family caregiver, primary care provider, and facility-based or community-based care manager, focused on health coaching and care coordination activities, aligned with member needs and preferences in reaching their health goals.
- Promotes access to and oversees the coordination and delivery of comprehensive, quality healthcare services for HIV-positive, transgender, and homeless members.
- Provides health education and coaching on HIV disease, HIV primary and secondary risk reduction, and other chronic co-morbid illnesses, including, but not limited to hepatitis C, diabetes, and hypertension, as indicated by the Plan of Care.
- Communicates with the member's primary care provider, community case manager, and all other applicable providers, vendors, or agencies to facilitate the health and wellness of the member in a coordinated and comprehensive manner.
- Identifies service utilization trends and potential member needs through review of encounter data, pharmacy/prescription data, and completed member health assessment tools.
- Ensures that goals, interventions, and care coordination activities for each member are documented in the electronic health record in compliance with professional standards and regulatory guidelines.
- Mentors and supports the work of HIV Services Health & Wellness Advisors on their assigned team and other teams when requested, and participates in the competency development of HIV Services Health & Wellness Advisors.
- Attends and prepares for periodic departmental case conferences as assigned. Reviews, identifies, and assesses the member Plan of Care and recommends changes to promote the health and wellness of the member.
- Assists other departments with resolution of member concerns related to retention, utilization management, quality management, customer service, and provider relations.
- Attends approved in-service and external education and training as per department directives.
- Performs, as assigned, other special projects and activities, including, but not limited to, audit review and preparation, quality improvement, community health education, facility/provider relations, and health plan promotion.
- Ensures that coordination of care activities for assigned caseload is compliant with Federal, State, and City regulations, and is consistent with the Mission, Vision, and Values of the organization.
- Master's degree from an accredited college or university in Social Work is required.
- A minimum of two years of clinical experience in HIV care or support systems that includes experience in care coordination, health education, and case management.
- Experience in managed care is preferred.
- Bilingual (English/Spanish) is preferred. Fluency in other languages is welcome.
- New York State license as an LCSW or LMSW.
- Integrity and Trust
- Customer Focus
- Functional/Technical Skills
- Excellent interpersonal, organizational, communication, and analytical skills.
- Computer literacy with proficiency in Microsoft Office products is required.
Please note that the salary range and/or hourly rate range of $40.00 to $45.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity).
For consideration for this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool.
At ATRIA Consulting, LLC, we are a woman-owned business that is fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We pledge to continue the fight against racism and any other form of bias. We embrace and celebrate our employees' differences in age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make us all unique. We are the collective sum of individual differences, life experiences, knowledge, innovation, self-expression, inventiveness, and talent. We encourage everyone to apply!
Recommended Skills
- Analytical
- Auditing
- Behavioral Medicine
- Business Requirements
- Care Coordination
- Case Management
Recommended Skills
- Analytical
- Auditing
- Behavioral Medicine
- Business Requirements
- Care Coordination
- Case Management
Professional Field


Patient Focus
Diagnoses
Avoidant Personality Disorder
Gender Dysphoria
Issues
Medication Management
Minority Health
Racism, Diversity, and Tolerance
Therapeutic Approach
Methodologies
ECT
Modalities
Families
Individuals
Practice Specifics
Populations
HIV/AIDS
School
Settings
Faith-based organizations
Partial Hospitalization (PHP)
Residential Treatment Facilities (RTC)
Home Health/In-home
Military
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