Social Worker, Utilization Management

QUALIFICATIONS:

Education, skills and experience:

* Degree: Masters in Social Work (MSW).

* Minimum 3 years previous experience working in managed care/healthcare settings, preferably with diverse patient populations.

* Experience providing guidance to patients and families on eligibility determination for social programs and funding sources from a variety of agencies.

* Experience providing counseling and crisis intervention skills preferred.

* Proficiency in electronic health records (EHR) and documentation systems required. Ability to maintain documentation in patient's record per internal, regulatory and professional standards.

* Must have valid driver's license and reliable transportation for travel within the community to various locations.

POSITION SUMMARY:

As part of the Utilization Management division, the social worker will intervene with members who have complex health and psychosocial needs and high-risk populations to ensure optimal clinical outcomes. Services may include consultation, discharge planning, education, crisis intervention, counseling, advocacy and information on referral services to assist members with emotional, social and financial factors that affect care.

In order to fully engage with members and their families, travel to hospitals, rehab or skilled nursing facilities and possibly member's homes, may be required. The ability to develop and maintain collaborative working relationships with FHCP colleagues and external vendors in providing case management services is essential to the role.