Description
General Summary of Position
Job Summary:
MedStar Health is looking for a Case Manager Social Work to join our MedStar Health Family Choice (MFC) team! We are looking for a licensed Social Worker with the ability to create, edit and analyze in Microsoft office (Word, Excel, and PowerPoint).
The Case Manager Social Work will coordinate, negotiate, procure and manage care of our members/enrollees to facilitate cost effective care to the members/enrollees' satisfaction. Facilitates the continuum of care, works collaboratively with interdisciplinary staff, internal and external to the organization.
Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses". Apply today and learn how MedStar Health can be your next great career move!
Primary Duties:
Acts as a liaison to MedStar Family Choice contracted vendors to facilitate care. Identifies gaps in contracted services and develops a plan to access care. Acts as an advocate while assisting members/enrollees to coordinate and gain access to medical, psychiatric, psychosocial, social determinant of health (SDOH) needs, and other essential services to meet their healthcare needs. Authorizes and monitors covered services according to policy.
Maintains working knowledge and collaborative relationships with District of Columbia and/or Maryland agencies and resources. Attends and participates in MFC staff meetings, Clinical Operations department meetings, Special Needs Forums, work groups, District/ community agencies meetings, etc., as assigned. Provides input, completes assignments, and shares new findings with other staff.
Attends court ordered hearings and helps with coordinating needed care. Identifies and reports potential coordination of benefits, subrogation, third party liability, worker's compensation cases, etc. Identifies quality, risk, or utilization issues to appropriate MedStar personnel.
Initiates contact with providers to obtain clinical information to facilitate approval or pending of pre-certification requests, as appropriate. Interfaces with the community for home visits or group meetings.
Maintains knowledge of MFC benefits and enrollment issues to accurately coordinate services. Maintains timely and accurate documentation in the clinical software system per Clinical Operations department's policies and workflows. Provides ACD telephone coverage and processes calls related to PCP (Primary Care Physicians) and provider questions, eligibility and benefits, transportation, and authorization issues. Works to actively develop and/or manage assigned case management programs, such as HIV, and behavioral health conditions as appropriate for the population served. Keeps informed about disease processes, treatment modalities, and resources.
Qualifications:
Master's degree in social work.
2 years recent care/case management experience.
3-4 years Diverse clinical experience.
3-4 years behavioral health per population served, if applicable.
Valid MSW (Master of Social Work) license in the District of Columbia and/or State of Maryland based on work location(s) or (LICSW (Licensed Independent Clinical Social Worker) in the District of Columbia and/or State of Maryland based on work location(s) or LCSW (License Clinical Social Worker) in the District of Columbia and/or State of Maryland based on work location(s) or Valid Licensed Graduate Social Worker (LGSW) in the District of Columbia and/or State of Maryland based on work location(s).
Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:
- Strong emphasis on teamwork—our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
- Strategic focus on equity, inclusion, & diversity—we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
- Comprehensive total rewards package—including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
- More career opportunities closer to home—as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.
MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.
Apply on company website
Find Connections via Linkedin
