VillageCare Redefining Wellness
112 Charles St., New York, NY
Job Title: Social Worker Care Manager, LMSW
Roles & Responsibilities:
The Social Worker Care Manager provides telephonic and in-home assessments of members status and needs, develops, implements, and monitors care plan, ensures continuity of care and monitors member's long term care needs.
Provides care management including care planning, coordination, and assessment of health, environmental, and psychosocial status members on an ongoing basis. These assessments will be conducted in the member's home or telephonically.
Identifies health, environmental, and psychosocial risks for assigned members and recommends appropriate interventions to Care Management Supervisor and the Interdisciplinary Care Team.
Provides on-going assessment of the effectiveness of the Member's plan of care and discusses and assist in the development a comprehensive Plan of Care in collaboration with the member, family, physician, and other interdisciplinary team members as appropriate by assessing and identifying the clinical, psychosocial and financial needs of the patient/family/caregivers and establishing mutually agreed upon goals utilizing evidence based guidelines as available
Assist with community resource identification, including entitlements such as food stamps
Assist in discharge planning of member from inpatient setting.
Educate members about NAMI and Medicaid Spend down/surplus.
Facilitates delivery of care and services with the goal of assisting members to obtain/maintain maximum health and functional capability
Gather information for Care Management Supervisor to assist with utilization review decisions, using clinical criteria as a guide for data collection
Makes requests for authorization to the Care Management Supervisor for new services and changes to the plan of care Assist, as needed, in the semi-annual reassessments using the New York State designated assessment tool and other plan defined assessment tools
Works collaboratively with the Interdisciplinary Care Team
Coordinates services that are covered and not covered to create a comprehensive care plan that meets the medical, psychosocial and financial needs of the member.
Documents care management activity within the VillageCareMAX system
Adheres to VillageCareMAX policies and procedures for timeliness in completing visits and assessments
Education: Minimum formal education of Master's Degree
Certification: Current NYS LMSW license and registration
Experience: Minimum of one (1) year job-related experience, MLTC preferred
Bilingual, must speak one of the following : Spanish, Mandarin, Cantonese, Russian
You are a team member who serves as a positive example and reflection of why others trust the intentions of VillageCare by:
Being honest and trustworthy
Meeting your commitments and obligations
Acknowledging your role in actions or events with unsatisfactory outcomes
Customer Focus/Cultural Awareness
You are a team member who understands the importance of strong customer service internally and externally and you demonstrate this by identifying customer needs and expectations, and responding to them in a timely and effective manner. You are consistently customer focused by:
Demonstrating an awareness of the needs of individuals through recognizing multiple levels of connections
Anticipates and prevents delays or other things that can adversely affect the customer.
Keeping customers informed about the status of pending actions and inquires
You are a team member who adjusts quickly and effectively to changing conditions and demands. You understand that change is a necessary and an inevitable aspect of organizational life as well as an opportunity to learn new things. As such, you are flexible and agile by:
Maintaining a positive view of potentially stressful situations
Accepting and adapting to organizational or departmental changes
Viewing change as opportunities for VillageCare to grow in a direction that better serves our clients and our employees
Result Oriented/Innovative Thinking
You are a team member who consistently looks for new and innovative approaches that will improve efficiency in your role. You champion new ideas and build upon existing processes by:
Using data/fact-based information to make decisions relevant your role
Understands that obstacles will occur and refuses to use them as an excuse for not achieving results
You are a team member that consistently supports VillageCare's larger organizational culture by displaying a commitment to the three cultural drivers that make VillageCare and our employees vital to the healthcare space by:
Exceeding expectations in both internal and external customer service areas
Using data and key information to inform decisions pertinent to your role (where applicable)
Utilizing relationships, tools and positivity to enhance organizational performance through communication and collaborative team work
VillageCare is committed to superior outcomes in quality health care. Do you share a common commitment to* patient care, customer service and passion *for individuals' well-being ?
With over 25,000 people served in 2017, VillageCare's mission is to promote healing, better health and well-being to the fullest extent possible.
VillageCare began in 1977 as a project by community volunteers to rescue and reorganize a for-profit nursing home slated for closure. It has become a much larger organization that provides post-acute care, community-based services and managed long-term care. As a result of this history, VillageCare has become a valued resource for the people we serve, their caregivers and other provider organizations with which we partner.
VillageCare is committed to the tenets of diversity and workforce that are strengthened by the inclusion of and respect for our differences. We offer our employees a highly competitive compensation and benefits package, a 403(b) retirement plan, and much more.
VillageCare is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.