Care Coordination Social Worker – Population Health

COPE Health Solutions; Salinas (CA); On-site; USD 79,000 - 110,000; Full time

Benefits offered by this job

Wellness stipend (yearly)

Paid parental leave

Competitive benefits

Job summary

COPE Health Solutions seeks a Social Worker to join a multidisciplinary healthcare team in a primarily in-person setting with telephonic support. The role focuses on coaching and coordinating care for patients navigating complex needs and post-clinical follow-up.

Responsibilities include ongoing assessment, implementing care plans, and connecting patients with community resources while aligning with cultural preferences and regulatory requirements.

Qualifications

• Valid and current MSW, LCSW or LMSW licensure.
• 3-5 years' care management and/or managed care experience.
• Experience with multidisciplinary healthcare teams and care coordination.

Responsibilities

• Assess identified members to determine suitable management early in disease.</br>Process and update care plans with input from the team.
• Coordinate with physicians, nurses, pharmacists and dietitians to address needs.
• Screen for behavioral health concerns and arrange appropriate interventions.
• Facilitate referrals, authorizations and follow-ups for patient care.
• Communicate care plans with members, families and providers.
• Document activities in designated technology platforms and stay compliant with regulations.

Skills

Care coordination

Multidisciplinary teamwork

EMR proficiency

Communication

Assessment & planning

Education

MSW, LCSW or LMSW licensure

Tools

EMR systems

Outlook

Data entry

Job description

COPE Health Solutions seeks a Social Worker to join a multidisciplinary healthcare team in a primarily in-person setting with telephonic support. The role focuses on coaching and coordinating care for patients navigating complex needs and post-clinical follow-up.

Responsibilities include ongoing assessment, implementing care plans, and connecting patients with community resources while aligning with cultural preferences and regulatory requirements.