- Working with Medi-Cal SPD Case Management appropriate providers and agencies to focus on care coordination of Medi-Cal members and their families to navigate through complex care needs.
- Provide psychosocial assessment of Medi-Cal SPD members through home visits. Provide community resources related to clothing, housing/homeless prevention, limited financial resources, home maintenance repair, referrals, food, safety in the home, transportation, and utilities assistance.
- Develop individual treatment plans and make recommendation for members. Implement treatment plan using appropriate modalities, including crisis intervention, community contacts, diversion and triage.
- Collaborate with Medi-Cal SPD Case Management professionals to identify drivers of hospital admissions; reduce hospital and ER admissions.
- Attend and contribute to Interdisciplinary Care Team meetings regarding care to/for specific member, including interpreting psychosocial implications of illness to attending staff and departmental staff as needed.
- Consult upon request of clinical and/or educational staff members and/or accept referral from Case Management or PCP office, for members needing resource information.
- Work with case managers in identifying members who are appropriate for hospice conversion or Palliative care, and assist the members and/or their families in accomplishing this process as requested.
- Assist with prescription referral source, education on how to obtain medical equipment, Advance Directives/Hospice choices, dental care referral source, non-compliant issues, and psychiatric condition interfering with medication regiment.
- Provide resources for family/Social Support; limited social support, parenting/educational skills, domestic violence, elder care, parent-child conflict, family relations issues, recreational activities, and information regarding Respite Care for caregivers.
- Assist with mental health assessment/referral sources to; individual therapy, family therapy, group therapy, anger management, behavior management, suicide prevention and alcohol/substance abuse.
- Provide evaluations (when requested) for Medi-Cal SPD members referred by Case Managers, Medical Directors, PCPs, or any other members of the Medical Management team, regarding possible placement, member financial concerns and/or ADL assistance needs.
- Interact professionally with member/family member, case management or other providers, keep them informed and provide support if further assistance is needed in a timely manner.
- Treat Medi-Cal members and their families with respect and dignity. Identify and address psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families. Functions as liaison between administration, patients, physicians, and other healthcare providers.
- Collaborate and communicate effectively with all members of the healthcare team (PCP, Case Management, providers) to coordinate the continuum of care of developing plans for management of each case, and participation in the interdisciplinary team
- Attend and participate in Department meetings.
- Assist in educational endeavors of department.
- Assist with chart auditing and maintain quality monitors as assigned by Manager
- Participate in orientation, instruction/training of new personnel.
- Pursue additional education (in-services, seminars, self study, and formal education programs) to advance skills and knowledge.
- Document appropriately pertinent information completely, in the electronic medical documentation system.
- Prepare reports and compiles statistical data regarding members, as determined by the management team.
- Protect privacy for both members and employees; ensuring all personal health information is kept confidential and comply with HIPPA regulations.
- Perform other duties as assigned.
- Employer-paid comprehensive medical, pharmacy, and dental for employees
- Vision insurance
- Zero co-payments for employed physician office visits
- Flexible Spending Account (FSA)
- Employer-Paid Life Insurance
- Employee Assistance Program (EAP)
- Behavioral Health Services
- 401k Retirement Savings Plan
- Income Protection Insurance
- Vacation Time
- Company celebrations
- Employee Assistance Program
- Employee Referral Bonus
- Tuition Reimbursement
- License Renewal CEU Cost Reimbursement Program
- Business-casual working environment
- Sick days
- Paid holidays
- Mileage
- Degree Requirements: Master's Degree.
- Licensed LCSW or MSW
- High level knowledge of Case Management processes and principles
- Knowledge Medi-Cal, HMO, Medicare and Cal MediConnect covered services
- Ability to work with all levels of management.
- Must have excellent communications skills both verbally and written
- Must have excellent organizational skills.
- Required to travel for member appointments.
- Must have working knowledge of MS Office environment, and EZ Cap
- Bilingual skills in any of the following languages preferred: Spanish, Farsi, Cantonese, Mandarin, Korean, or Vietnamese.
- Must have experience working with a diverse member population, primarily consisting of senior members.
- Require current CA driver's license and car insurance.
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Social Worker - San Bernardino, United States - Regal Medical Group
Description
Job DescriptionPosition Summary:
Under the direction of Senior Manager, Social Services and collaborating closely with the Medi-Cal SPD Case Management Team, the Medi-Cal SPD Social Worker is responsible for assisting in the successful implementation of the newly launched Medi-Cal SPD (Seniors and Persons with Disabilities) Medical Management Program. This program is designed to provide individualized assessment and care management to Medi-Cal SPD members who are at high risk for preadmissions, readmissions and for members at risk for complex hospitalizations and/or long term health management needs. The Medi-Cal SPD Social Worker will provide in-depth psychosocial assessment of Medi-Cal SPD members through home visits and develop care plan in collaboration with Medi-Cal SPD Case Management and other health care practitioners. In addition, the Medi-Cal SPD Social Worker will provide knowledge, expertise, resources that are specific to Medi-Cal SPD members as well as information and referrals to community resources and services; and benefits. Further, Medi-Cal SPD Social Worker will support other programs as required.
The goal of Medi-Cal SPD Program is to establish early identification and focused care coordination of high risk members at risk for admissions, readmissions and complications related to identify risk factors and to educate and facilitate appropriate services for the member. To this end, the Medi-Cal SPD Social Worker will collaborate closely with Medi-Cal SPD Case Management to effectively manage our members to assure that appropriate level-of-care is provided, to prevent member re-admissions and ensure that the member's medical, environmental and psychosocial needs are met.
Essential Duties and Responsibilities include the following:
The Medi-Cal SPD Social Worker is responsible, along with other members of Medical Management Team, for contributing to the clinical, quality, financial and patient satisfaction outcomes of Regal Medical Group. Provide assistance to members and their families in the form of social services guidance, resource referral, and crisis intervention as required. Interpret psychosocial implications of illness to attending Providers and staff as needed. Capable of being independent with decision-making within the Scope of Practice and Job Description.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
Education and / or Experience:
