Full Time Case / Disease Management - Social Worker (LISW)
Social Worker (LISW), Roma Location
Overview of Position: Co-manages members with case and disease
managers to assess, plan, facilitate and monitor options and
services required to meet an individual’s healthcare needs, while
promoting quality, and cost effective outcomes for members with
complex psychosocial needs. Serves as liaison to teammates,
Providers and patients as needed. Responsible for providing
clinical social work services to members and families on an
outpatient basis including, crisis intervention, short-term case
management, and providing information and referrals to community
resources. This is performed under the direct supervision of the
Medical Director, Care Management.
Performs psychosocial evaluations of member’s physical, social
and emotional functioning as well as financial and family support
Develops a treatment plan or plan of care which includes
arrangements for referral to services as appropriate. Assists
Care Managers with care coordination and discharge planning for
patients with complex discharge needs.
Provides community resource information to case and disease
managers, providers, or directly to members or families.
Acts as a consultant to members requiring information on
Advanced Directives or Power of Attorney.
Participates as appropriate in scheduled Case and Disease
Management Huddles to present information regarding member status,
care coordination efforts, resources provided, and to provide
guidance to fellow teammates regarding resources for members.
Documents social work interventions by inclusion of reports in
medical records and referral management system as needed.
Maintains statistical data on social work treatment plan,
intervention and outcomes.
Participates on an assigned basis in educational training for
teammates and providers related to the psychosocial aspects of
physical and emotional illness/disability.
Acts as a resource to department teammates, organization
teammates, and Providers for difficult to manage members.
Maintains current information on all frequently used community
resources, financial resources and placement facilities.
Routinely updates resource list and is available to discuss how to
resource required services.
Identifies and intervenes with high-risk patients requiring
Uses, protects, and discloses Optum patients’ protected health
information (PHI) only in accordance with Health Insurance
Portability and Accountability Act (HIPAA) standards.
Performs additional duties as assigned.
Education: Required- Master’s degree or higher in healthcare
related field and applicable licensure, (i.e. LISW or other
applicable licensure demonstrating appropriate scope of
Preferred- Certified Case Manager
Experience: Three (3) years of previous job related
experience in a healthcare environment.
Preferred- Two (2) years’ experience providing case management
and/or utilization review functions within health plan or
Required licensure: Required- NM licensure providing ability to
perform duties required of position, (i.e. LCSW) Preferred-
Utilization Review or Case Management Certificate.
Knowledge, Skills, Abilities: PC proficient; ability to
communicate and interact professionally with co-workers, management
patients, and Providers; ability to counsel and/or consult;
working knowledge of HMO’s, PPO’s, Medicare, Medicaid, and
insurance plans; knowledge of CPT4/ICD 9 & 10/HCPCS codes.
ADDITIONAL REQUIREMENT : Must pass a nationwide criminal history
screen through the Caregivers Criminal History Screening
Careers with Optum. Here's the idea. We built an entire
organization around one giant objective; make health care work
better for everyone. Optum, part of the UnitedHealth Group family
of businesses, brings together some of the greatest minds and most
advanced ideas on where health care has to go in order to reach its
fullest potential. For you, that means working on high performance
teams against sophisticated challenges that matter. Here you’ll
find incredible ideas in one incredible company and a singular
opportunity to do your life's best work.(SM)
Diversity creates a healthier atmosphere: Optum and its
affiliated medical practices are Equal Employment
Opportunity/Affirmative Action employers and all qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex, age, national origin, protected
veteran status, disability status, sexual orientation, gender
identity or expression, marital status, genetic information, or any
other characteristic protected by law. Optum and its affiliated
medical practices is a drug-free workplace. Candidates are required
to pass a drug test before beginning employment.