Company Statement
Connecticare is a leading health plan in the state of Connecticut and a subsidiary of EmblemHealth, a health and wellness company that provides insurance plans, primary and specialty care, and wellness solutions. WellSpark is a digital wellness company and national subsidiary of EmblemHealth that offers a full suite of products and solutions to reward people for healthy behaviors.
Social Worker
Summary of Job - Hybrid
Achieve optimal benefit and results from the comprehensive management of members with chronic and/or catastrophic illness, members who are frail elderly and/or members whose illness is complicated by challenging psychosocial conditions. Provide global, episodic, specialized or complex care management and utilization management as needed to ensure coordination of health care delivery, member education, and preventative intervention.
Coordinate care in a variety of settings and provides focus on transition activities to benefit clinical needs of members while performing the care management process. Assist in managing members with behavioral health, substance abuse, and/or psychosocial conditions/issues, consulting with
colleagues across the enterprise. on behavioral health, substance abuse, and/or psychosocial issues. Facilitate member adoption of strategies to promote physician recommended behavior changes. Help members improve health outcomes and provide feedback to members of the medical and care management care teams.
Responsibilities
• Develop, facilitate, and communicate a plan of care in partnership with the member, his/her significant other, primary caregiver, the primary and attending physicians, and various providers.
• Provide care management through assessment, planning, implementation, coordination, monitoring, and evaluation to ensure member receives services and supports required to meet psychosocial, educational and health care needs.
• Assist members with the coordination of services from various settings as appropriate. Include facilitating discharge from acute setting to home and acute setting to alternate settings. Provide Care Coordination throughout the continuum of care by including the member, member’s family and providers in the process.
• Assess identified members to determine members appropriate for management early in their disease process at any time during the continuum of care.
• Assess members’ Social Determinants of Health, such as housing, food, transportation, and safety in the home; assess members’ mental health needs including PHQ2 and 9 Depression screening.
• Provide mental health counseling referrals and provide appropriate support as needed.
• Optimize the quality of care and of life for the member. Identify members appropriate for specialty programs.
Qualifications
• Bachelor’s degree (Required)
• Master's in Social Work - LMSW (Required)
• Certification in clinical social work - LCSW (Preferred)
• 4 – 6+ years of case management and/or managed care experience (Required)
• Knowledge of Federal and State regulations for Medicare and Medicaid and other national and state funded programs (Required)
• Knowledge of community resources access (Required)
• Proven track record in leading care management teams (Required)
• Health plan experience (Preferred)
• Strong problem-solving skills (Required)
• Detailed oriented and organized (Required)
• Excellent communication skills - verbal, written, presentation, interpersonal (Required)
• Proficient with MS Office - Word, Excel, PowerPoint, Teams, Outlook, etc. (Required)
Security Disclosure
If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.
We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.
Pay Disclosure
A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.
EEOC Statement
We are committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, national origin, disability, protected veteran status or any other characteristic protected by law.