Case Manager, Mid

Acentra Health, LLC; West Virginia; On-site; USD 67,000 - 73,000; Full time

Benefits offered by this job

Health plans

Paid time off

Retirement savings

Educational assistance

Job summary

Acentra Health, LLC is seeking a Case Manager, Social Worker to join our growing team. The role focuses on evaluating beneficiaries' needs, developing care plans, and coordinating healthcare team members to achieve optimal outcomes while adhering to payer requirements.

Responsibilities include assessing and planning across the continuum of care, utilizing clinical knowledge and communication skills, and documenting results in our web-based database.

Qualifications

• Bachelor’s degree in Social Work is required.
• MSW or CCM is preferred.
• Active, unrestricted SW license is required.
• Minimum 3 years of Social Work experience with older adult population in a healthcare environment; 3–5 years plus 1–3 years of case management review experience.

Responsibilities

• Assess, plan, implement, monitor, and evaluate options to create an individualized plan for the beneficiary across the continuum of care.
• Utilize clinical knowledge, communication, problem-solving, and conflict resolution to achieve optimal outcomes.
• Develop beneficiary-centered care plans and coordinate with providers and caregivers.
• Maintain confidentiality and comply with HIPAA and related policies.
• Document assessments accurately in the web-based database with timely entries.

Skills

Communication skills

Confidentiality

Teamwork

Customer service

Multi-tasking

Education

Bachelor’s degree in Social Work

MSW or CCM preferred

Tools

Microsoft Word

Microsoft Excel

Job description

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision-making, and drive better health outcomes. We value professionals who are curious about new technologies and motivated to use innovative tools to increase efficiency, quality, and impact in their roles.

Job Summary and Responsibilities

Acentra Health is looking for a Case Manager, Social Worker to join our growing team.

Job Summary:

• The Case Manager, Social Worker will evaluate beneficiaries' needs, develop individualized careplans, and coordinates healthcare team members to ensure optimal client outcomes whileadhering to payer requirements. They also facilitate integrated case and disease managementactivities based on CMSA principles, aiming to stabilize beneficiaries' health and avoid long-termcare placement.

Responsibilities:

• Assess, plan, implement, monitor, and evaluate options and services to affect an appropriate,individualized plan with the beneficiary across the continuum of care.
• Utilize clinical knowledge and competence, communication skills, problem-solving, andconflict resolution to ensure optimal beneficiary outcomes with consideration to clientrequirements effectively.
• Develop beneficiary-centered care plans.
• Demonstrate shared accountability between beneficiaries, caregivers, and providers.
• Work collaboratively with the beneficiary, provider, and other Funds Health Care teammembers to coordinate care.
• Address identified gaps in care or compliance.
• Maintain strict standards for client confidentiality and client-related information.?
• Comply with all organizational, state, and federal regulations and policies on confidentiality.
• Manage caseload to ensure all required documentation and entry of assessment results intothe web-based database are completed accurately and timely, following regulatoryrequirements and company policies and procedures.
• Maintain open communication with all appropriate parties.
• Pursue ongoing education, certification, and self-development to remain current with casemanagement standards.
• Read, understand, and adhere to all corporate policies including policies related to HIPAAand its Privacy and Security Rules

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications

Required Qualifications

• Bachelor’s degree in Social Work Required.
• Master of social work (MSW) or?Case Management Certificate (CCM) Preferred.
• Active, unrestricted SW license
• Minimum 3 years of Social Work experience w/older adult population in a healthcare
• Environment 3 - 5 years?of clinical experience with a?minimum of 1-3 years of case management review experience required.

Preferred Qualifications

• Proficiency in using Microsoft Word, Excel, and other applications in the Microsoft Officesuite.
• Excellent written and verbal communication skills.
• Ability to work effectively in a team environment.
• Maintain a high level of confidentiality.
• Good problem-solving skills.
• Ability to maintain metrics and goals within the department.
• Work telephonically, and with computer systems.
• Assist members and conduct outreach to members without prior engagement.
• Flexibility and strong organizational skills.
• Strong understanding of cultural competency when working with the population.
• Experience with commercial health plans.
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superiorattention to detail and demonstrated ability in decision-making.
• Demonstrated initiative and judgment in the performance of job responsibilities.
• Maintain professionalism, flexibility, and dependability under pressure.
• Strong communication (written/verbal), interpersonal, organizational, time management andcommunication skills with a strong focus on customer service, including building andmaintaining relationships with internal/external customers and facilitating meetings.
• Ability to work independently and as part of a team.
• Ability to research/identify and apply appropriate standards of care.
• Interest in continuous learning and a commitment to staying informed on regulatory changes.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Salary and Compensation

USD $67,300.00 - USD $73,000.00 /Yr.

We are committed to providing a secure and positive hiring experience. Depending on the role, interviews may be conducted virtually, in person, or through a combination of both. As part of our recruitment process, candidates may be asked to participate in identity verification measures to help ensure the integrity of the hiring process.

~ The Acentra Health Talent Acquisition Team

EEO

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.