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Social Worker - ST Case Management preferred

IBM Type Full time Posted 7/1/2014
Salary - n/a - Starts - n/a -
GA - Georgia (All) - Augusta Referral 1405162    

Company Overview:

WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled, as well as prescription drug plans. The company serves approximately 3.3 million members nationwide as of January 1, 2014. The company employs more than 5,100 nationwide. For more information about WellCare, please visit the company's website at www.wellcare.com. A Fortune 500 company traded on the New York Stock Exchange (symbol: WCG).

EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.

 

Description:

Coordinates the socio economic needs and service of selected member populations across the continuum of illness. Interviews, coordinates and plans activities and behavioral routines to meet the medical, social and emotional needs of members and their families. Provides support and/or intervention and assists members in understanding the implications and complexities of their current medical situation and/or overall personal care. Collaborates with the interdisciplinary team to achieve optimal resource outcomes. Works with Case Management to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of the Member.

 

Essential Functions:

  • Participates in and supports developed care plans for members utilizing social service expertise to evaluate the members need for alternative services and third party needs.
  • Outreaches to members telephonically and/or in-person and coordinates member's case management services.
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address/support medical needs. Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
  • Provides telephone follow-up to ensure members have seen their PCP and are completing their treatment plan or preventive care services a defined by the PCP or guidelines.
  • Coordinates community resources with emphasis on the development of natural support system. Coordinates benefits, regulations, laws and public entitlement programs.
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
  • Assists in obtaining benefits for members through community resources when benefits are exhausted or not available.
  • Performs other duties as assigned.

 

Education:

  • A Bachelor's Degree in Social Work (BSW)

 

Experience:

  • 2-4 year's relevant social work experience.
  • Experience in a managed care environment.

 

Special Skills (e.g. 2nd language:

  • Ability to work independently, handle multiple assignments and prioritize workload
  • Communicates effectively in person and by phone
  • Advanced ability to communicate on any level required to meet the demands of the position
  • Ability to create, review and interpret treatment plans

 

Technical Skills/Requirements:

  • Proficient in Microsoft Office including Outlook, Word and Excel.
  • Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties.