Company :Highmark Inc.
Job Description :
This job functions as a member of a multi-disciplinary team that assists members across the continuum of health related services. The depth of engagement with the member varies with members' individual needs but includes the ability to comprehensively assess members' psycho-social and medical needs and develop interventions appropriate to members' situations. The goals are to help develop and support the member’s ability to self-manage, navigate the health care system, and provide members with resources and tools to assist in health-related decision making. The incumbent identifies, addresses, and coordinates efforts to assist members to achieve their personal health goals.
- Identify and address the health, social, familial, financial, and community resource needs of the Organization's members using a broad set of clinical and motivational interviewing skills.
- Conduct assessments telephonically and potentially in-person depending on the model of care delivery. These assessments address the needs of members with the goal of improving members’ self-management and supporting positive behavior changes.
- Develop and implement a comprehensive social worker case management plan of care which includes member/caregiver preferences.
- Establish a plan for regular contact with each member to review progress and assess the potential for additional needs.
- Evaluate and coordinate services to meet member specific health care needs.
- Communicate with the member’s treating provider(s) when indicated.
- Identify and promote the use of on-line, telephonic, and community-based resources and serves as a member advocate by assisting members to access those services.
- Assist members to make informed decisions across the continuum of health ranging from health promotion to end-of-life.
- Respectful of the member’s right to autonomy and dignity.
- Adhere to the professional discipline code of ethics.
- Collaborate with case manager and all other members of the multidisciplinary team to provide co-management activities for members who require additional services.
- Participate in ongoing training and educational activities related to medical and behavioral health topics.
- Ensure that all activities are conducted and documented in compliance with applicable regulatory requirements and accreditation standards.
- Other duties as assigned or requested.
- Master's Degree in Social Work or Social Welfare
- 5 years of post-graduate experience with experience as a Social Worker in an inpatient, outpatient, home health, or other healthcare setting where medical social work services are provided
- 2 years in Case Management related activities
- Strong clinical knowledge with In-depth knowledge of community resources
- Advanced training and experience in motivational interviewing
- Experience working with the healthcare needs of diverse populations and working with health plan related activities
- Experience in telephonic work environment
- Ability to communicate effectively in more than one language
LICENSES OR CERTIFICATIONS
Required (one of the following)
- Licensed Social Worker (LSW)
- Licensed Clinical Social worker (LCSW)
- Certification in Case Management
- Understanding of the importance of cultural competency in addressing targeted populations
- Understanding of the role of lifestyle in disease processes
- Basic computer skills, including Microsoft Office products
- Ability to work collaboratively and function as a team member in a professional environment
- Demonstrated ability to manage multiple priorities and perform work independently
- Evidence of ability to analyze outcomes and develop goal-oriented action plans
- Demonstrated analytical and decision-making skills
Language (other than English)
75% - 100% in the enhanced care model arena
PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS
Teaches/Trains others regularly
Travels regularly from the office to various work sites or from site-to-site Occasionally
Works primarily out-of-the office selling products/services (Sales employees)
Does Not Apply
Physical Work Site Required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )
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