Social Work Case Manager Sr - Asheville, NC - Ps27469

Anthem, Inc. Asheville , NC 28804

Posted 2 months ago

What Is CareMore?

CareMore is entering a new growth phase, as a proven care delivery model for the highest-risk. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients and currently serve nearly 200,000 patients in multiple states across Medicare, Medicaid, and commercial populations. We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience. As an Anthem subsidiary, we benefit from the scale and resources one of America's largest managed healthcare organizations.

CareMore's Health Networks, Primary Care+, Touch and CareMore@Home models drive strategy, operations, and care delivery in our national markets (Arizona, California, Colorado, Connecticut, Iowa, Nevada, New York, North Carolina, Tennessee, Texas, Virginia and the District of Columbia), where CareMore builds and runs capitated primary care medical groups, at-risk health networks and upstream care delivery products in service of high-risk Medicaid, Medicare and commercial patients, and our collaboration with Emory Health System in Georgia. Our comprehensive, upstream approach to health is led by robust multidisciplinary teams of extensivists (managing acute and post-acute episodes of care), primary care clinicians, behavioral health clinicians, care management & engagement specialists (including social workers, case managers and community health workers), and mobile home-based care teams. We continue to evolve our model to effectively engage and care for complex patients, led by a team of passionate, execution-minded leaders dedicated to this mission.

For more information, visit http://www.caremore.com/

Job Responsibilities:

  • Responsible for performing social work case management services by making integrative psychosocial assessments, developing, implementing, coordinating, monitoring, and evaluating social work goals designed to optimize members access to social services across the care continuum and ensuring member access to services appropriate to their psychosocial needs.

  • Primary duties may include, but are not limited to: Conducts psychosocial assessments to identify individual needs and a specific social services/psychiatric needs to address objectives and goals as identified during assessment. Implements social work goals by advocating for members needs. Networks with other community resources.

  • Provides referrals within benefits structure. Develops and implements a metric system that tracks baseline levels of functioning throughout course of social work services by constructing necessary instruments that focus on identified psychosocial needs.

  • Coordinates specific psychosocial resources to meet members identified needs. Monitors and evaluates effectiveness of the social work goals. Interfaces with Registered Nurse Care Managers and Management on the development, implementation, and progress of social work goals, and the members responsiveness to resources rendered.

  • Evaluates members' ability to independently manage self and locate alternative resources when limitations are identified.

  • Provides guidance to members seeking alternative solutions to specific social, cultural or financial problems that impact their ability to manage their healthcare needs.

  • Evaluates members' strengths related to health self-management, develops strategies to support healthcare needs and implements plans in support of case decisions.

  • Facilitates and coordinates behavioral health resources as individual member needs are identified.

  • Participates in social work case audit activities and assists supervisor with management of day-to-day activities, such as monitoring and prioritizing social work task-list workflow.

  • Serves as first line contact for conflict resolution.

  • Develops a medical social work module of training for staff social workers.

  • Develops training materials, completes quality audits, performs process evaluations, and tests and monitors systems/process enhancements.

  • Serves as a team lead, manages the most complex cases, assists in policy and procedure development, and leads projects with cross-functional teams or serves as a representative on enterprise initiatives.

Required:

  • MS (at a minimum) in Social Work

  • 5 years of experience in case management in a health care environment; or any combination of education and experience, which would provide an equivalent background.

  • Current unrestricted LMSW or LCSW (or equivalent) license in applicable state(s) required.

Preferred:

  • Bilingual (Spanish) or multi-language skills

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.


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Social Work Case Manager Sr - Asheville, NC - Ps27469

Anthem, Inc.