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- Work with the senior health plan medical director, regional medical officers, concurrent review nurse(s), and hospital team in implementing solution-focused interventions, in response to assessment findings.
- Document social work interventions and plan of care in health plan's UM platform within the same day of discussion.
- Provide appropriate interventions to optimize health and well-being. Interventions may include education, the coordination of community-based support services, as well as care coordination to mental health providers.
- Follow through with all recommendations to ensure success or to develop an alternate plan.
- Attend daily inpatient rounds and any interdisciplinary team (IDT) meetings as indicated.
- Performs duties in accordance with social work standards of practice and based on licensure scope.
- Unrestricted, California Social Work license (LCSW) or master's degree in social work (MSW) required from an accredited school of social work by the Council on Social Work Education.
- Minimum 3 years' experience in care management and working with geriatric, vulnerable population.
- Experience with motivational interviewing.
- Possess strong interpersonal skills to interact effectively with multi-disciplinary team members.
- Possess strong written and verbal communication.
- Able to work independently.
- Strong computer proficiency.
- Experience with Microsoft Office: Outlook, Word, and Excel.
- Background and understanding of palliative care and hospice programs preferred.
- Spanish speaking preferred.
- Recent experience in working with a Medicare Advantage plan preferred.
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Social Worker, Utilization Management - San Francisco, United States - Alignment Healthcare
Description
Job Number: 6688Workplace Type: Fully Remote
Position Title: Social Worker, UM
External Description:
Overview of the Role:
Alignment Health is seeking a utilization management (UM) social worker to join the utilization management team. As a social worker, you will assess the psychosocial needs of the Alignment Health catastrophic population. You will conduct telephonic outreach to members, families, caregivers, and facility staff to determine the resources that can be offered to maintain a members' needs in a safe and healthy environment. The focus will be to initiate outreach to the population that has been in an acute care setting but can extend to other levels of care. You will also work collaboratively with internal team members and other departments at the direction of the leaders of department.
If you are seeking an opportunity to learn and grow and be a part of an organization positively impacting the lives of seniors, we're looking for YOU
Responsibilities:
City: Remote-US
State: California
Location City: Remote-US
Location State: California
Community / Marketing Title: Social Worker, Utilization Management
Company Profile:
By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?
At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that's in a clinical setting, our corporate office or a home office, creativity and innovation flourish Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career - with us.
EEO Employer Verbiage:
Please note: All clinical positions are contingent upon successful engagement with Alignment Health's COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email [email protected].
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