Description:Position SummaryWe are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Licensed Social Workers to join our Case Management team. Our organization promotes autonomy through a Monday-Friday working schedule. Case Manager SW is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to client programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in g functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.Required Qualifications :Active and good standing Licensed Social Worker (LSW) for Ohio- 3+ years of behavioral health or social work experiencePreferred Qualifications- Case management experience- Community social work experience- Computer Skills (Microsoft office such as: Word, Excel, and outlook)DutiesConduct comprehensive assessments of member needs and eligibility by evaluating member benefit plans and available services.Develops strategies to reduce risk factors and address complex clinical indicators that impact care planning and issue resolution.Adapts clinical guidelines, standardized case management procedures, and regulatory standards to needs assessments to ensure appropriate administration of benefits.Conduct face to face visits with members in nursing home or community setting.Experience- Minimum 3 years of case management experience preferredEducationLicensed Social Worker (LSW)Notes:M-F 8-5 PM EST- Must be willing and able to travel up to 50-75% of the time in client location Reliable transportation required. Mileage is reimbursed per company expense reimbursement policyVIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Description:
Position Summary
We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Licensed Social Workers to join our Case Management team. Our organization promotes autonomy through a Monday-Friday working schedule. Case Manager SW is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to client programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in g functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.Required Qualifications :Active and good standing Licensed Social Worker (LSW) for Ohio- 3+ years of behavioral health or social work experiencePreferred Qualifications- Case management experience- Community social work experience- Computer Skills (Microsoft office such as: Word, Excel, and outlook)DutiesConduct comprehensive assessments of member needs and eligibility by evaluating member benefit plans and available services.Develops strategies to reduce risk factors and address complex clinical indicators that impact care planning and issue resolution.Adapts clinical guidelines, standardized case management procedures, and regulatory standards to needs assessments to ensure appropriate administration of benefits.Conduct face to face visits with members in nursing home or community setting.Experience- Minimum 3 years of case management experience preferredEducationLicensed Social Worker (LSW)Notes:M-F 8-5 PM EST- Must be willing and able to travel up to 50-75% of the time in client location Reliable transportation required. Mileage is reimbursed per company expense reimbursement policy
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