Social Worker, Case Management (MSW)
Jersey City, NJ
New York, NY
Apply here https://lumeris.wd1.myworkdayjobs.com/en-US/LC/job/Edison-NJ/Social-Worker--Case-Management_R0002996/apply
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Social Worker, Case Management (MSW)
The Social Work position in the Case Management department at Lumeris coordinates the socioeconomic and psychosocial needs and services of selected members across the continuum of care through the identification and arrangement of community resources and plan benefits. The Social Worker collaborates with an interdisciplinary team, members, and their caregivers to achieve optimal utilization and coordination of medical resources related to case management, disease management and discharge planning. The Social Worker provides support and/or intervention and assists members in understanding the implications and complexities of their current medical/social situation and/or overall personal care.
Role and Responsibilities:
Coordinate psychosocial services for members identified as having special needs and assist the members with utilization of medical resources related to case management, disease management and discharge planning.
Through needs assessments and health screens, identify psychosocial and economic barriers for accessing services and recommend appropriate resources to overcome barriers.
Interact with members, family, physician(s), case managers and other resources to determine appropriate action needed to address/support medical/psychosocial needs.
Review benefits options, research community resources, coordinate services, train/create behavioral routines and enable members to be active participants in their own healthcare.
Participate in case conferences to strategize and develop member specific care plans.
Participate in activities to develop, review or revise new or existing medical management programs as directed
Identify and arrange community resources for assistance with psychosocial and/or socioeconomic problem resolution.
Maintain appropriate documentation for all contacts and interventions.
Maintain HIPAA standards and ensure confidentiality of protected health information.
Report critical incidents and information regarding safety, elder abuse, and/or quality of care issues to include appropriate agencies, e.g. protective services as appropriate.
Ensure compliance with all state and federal regulations and guidelines in day-to-day activities.
Perform special projects as assigned.
Experience, Qualifications, and Education:
LCSW, MSW and licensed in New Jersey, eligible for licensure in other states as required
Minimum of 2 years of clinical experience
Experience in a managed care environment preferred
Communicates effectively in person, by phone, and by written communication
Ability to work independently, handle multiple assignments, and prioritize workload
Lumeris is an EEO/AA employer M/F/V/D.
Edison, NJ, Jersey City, NJ, Newark, NJ, New York, NY
Join Our Growing Team!
Lumeris is a value-based care managed services operator for health systems and providers seeking extraordinary clinical and financial outcomes. Lumeris aligns providers and payers across populations with technologies, processes, behaviors and information to achieve high-quality, cost-effective care with satisfied consumers — and engaged physicians.
For the past eight years, Lumeris with Essence Healthcare, its inaugural client and learning laboratory with more than 65,000 Medicare members in Missouri and Illinois, has received 4.5- to 5-Star Ratings from the CMS and produced the highest consumer and physician satisfaction scores in the industry along with significantly better clinical outcomes and lower costs. For more information, go to www.lumeris.com.
Why Join Lumeris?
At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.