As a member of the Care Team, the social worker supports the patient and family regarding benefits, community resources, referrals for counseling and other behavioral health needs. In addition, the social worker must be able to assist the patient in a sensitive and supportive manner, while acting as an advocate on behalf of the patient.
Essential Functions and Responsibilities for the Job:
Contributes effectively to the overall function and organization of the Medical Management Department for Memorial Medical Foundation
Assess, develop and deploy follow thru for all activities and UM/CM delegation requirements
Monitor and implement all regulatory changes impacting care
Be at work and be on time
Follow company policies, procedures and directives
Interact in a positive and constructive manner
Prioritize and multitask
Previous experience functioning as a social worker in a health care environment required.
General knowledge of health care delivery systems and regulatory requirements required.
Proficiency in computer and software utilization in support of job functions required.
Experience functioning as a social worker within a managed care environment preferred.
Working knowledge of NCQA (National Committee for Quality Assurance) SNP (Special Needs Plans); DMHC (Department of Managed Health Care), and other managed care regulatory requirements preferred.
Bilingual verbal skills in Spanish or another threshold language preferred