Case Manager, Social Services

Hpsj Mvhp; Modesto (CA); Remote; USD 72,000 - 102,000; Full time

Job summary

A leading health care organization is seeking a Case Manager for Social Services to provide intervention services. This role involves assessing psychosocial factors, developing care plans, and collaborating with various stakeholders. The position is remote, requiring California residency, and offers a competitive salary range based on experience.

Qualifications

• At least three years as a social worker in a health care setting.
• Experience working with Medi-Cal and other government sponsored programs preferred.

Responsibilities

• Conducts initial review for selected members and triages as appropriate.
• Develops social service care plans in partnership with members and providers.
• Monitors and evaluates progress at appropriate intervals.

Skills

Psychosocial assessment

Problem-solving

Communication

Customer service

Time management

Education

Bachelor’s Degree in Social Work

Bachelor’s Degree in Psychology

Tools

Word

Excel

Job description

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Health Plan of San Joaquin/Mountain Valley Health Plan provided pay range

This range is provided by Health Plan of San Joaquin/Mountain Valley Health Plan. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$72,110.00/yr - $101,800.00/yr

The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

We are currently hiring a Case Manager, Social Services to join our team!

Must reside in California - remote position.

Summary

Under general direction, the Social Services Case Manager is responsible for providing intervention services to assist members and their families in coping with social problems that accompany medical conditions or inhibit recovery in a manner that supports quality, cost effective care, and is consistent with department objectives and applicable regulations. Work is varied and moderately complex and requires a limited degree of discretion and independent judgment.

Supervises

• None.
  
  

Essential Functions

• Conducts initial review for selected members, triages as appropriate.
• Assesses psychosocial factors that may have an effect on health or recovery for identified members.
• Develops social service care plans in partnership with member, his/her provider, and HPSJ staff.
• Collaborates with member, his/her family, caregiver, and internal and external resources to ensure understanding of and compliance with care plans.
• Provides and coordinates resource contacts, and/or referrals to appropriate professional or community resources.
• Monitors and evaluates progress at appropriate intervals; conducts appropriate interventions.
• Assists RN case managers and concurrent review nurses with case management, and discharge planning and other member transition needs.
• Assist CM & CCRN in assessing members for Mental Health/Behavioral needs and refer to appropriate resources to meet needs.
• Performs community outreach for selected members as assigned.
• Supports and advises members on self-advocacy efforts.
• Documents activities in appropriate HPSJ system(s) according to standards; maintains records according to standards.
• Tracks data as required; compiles data for, produces and submits routine reports.
  
  

Non-Essential Functions

• Other duties as required.
  
  

Required

Education and Experience

• Bachelor’s Degree in Social Work, Psychology or other fields related to social services.
• At least three years as a social worker in a health care setting; OR.
• Equivalent combination of education and experience.
  
  

Preferred

• Experience working with Medi-Cal and other government sponsored programs.
• Experience working in a managed care setting.
  
  

Licenses, Certifications

None

Required

Knowledge, Skills, Abilities and Competencies

• Produces work that is accurate and complete.
• Produces the appropriate amount of work.
• Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
• Rebounds from setbacks and adversity when facing difficult situations.
• Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
• Strong psychosocial assessment skills.
• Basic knowledge of chronic and acute disease and how they impact health conditions and social functioning.
• Strong knowledge of and proficient skills in administering protocols.
• In-depth knowledge of community resources related to healthcare.
• In-depth knowledge of medical policy benefits and exclusions.
• Ability to read, interpret and apply complex written regulations, guidelines and other materials; ability to read and interpret basic clinical information.
• Strong analytical and assessment skills.
• Strong problem-solving skills.
• Basic negotiation skills.
• Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
• Ability to use tact and diplomacy to diffuse emotional situations.
• Strong oral and written communication skills, with the ability to communicate professionally to diverse individuals inside and outside of HPSJ, effectively explain complex information and document according to standards.
• Strong customer service skills.
• Ability to work independently and as part of a team.
• Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend a broader range of activities. Meets deadlines.
• Basic skills in Word and Excel.
• Ability to enter data into and navigate through multiple databases.
• Ability to speak and be understood in English.
• Ability to handle confidential information with appropriate discretion.
  
  

Preferred

• Proficient (as defined by HPSJ’s Cultural and Linguistics Program) in one of HPSJ’s threshold languages.
• Basic knowledge of the principles, practices and regulatory requirements of managed care.
• Knowledge of Medi-Cal or other government sponsored programs and regulations as they apply to social work.
  
  

Physical Demands

• Frequent sitting, standing and walking.
• Frequent repetitive motion – keyboarding and writing.
• Frequent talking and listening in person and over the phone.
• Occasional handling of materials up to 10 lbs.
• Close up and distance vision requirements.
• Occasional travel.
  
  

Emotional/Psychological Demands

• Ability to cope with: frequent interruptions; working occasional long hours; emotional and sensitive situations; frequent public contact.
  
  

Work Environment

Open office environment; moderate temperatures; moderate noise levels.

Eligible for remote work.

We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics, or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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