Field Social Worker: Care Coordination & SDOH Advocate

Optum; Albuquerque (NM); On-site; USD 60,000 - 107,000; Full time

Benefits offered by this job

Benefits package

Job summary

UnitedHealth Group, operating through Optum in Albuquerque, is seeking a compassionate Social Worker to support high-risk members by addressing social determinants of health, behavioral health needs, and barriers to care. You will conduct psychosocial assessments, develop resource plans, and help members navigate complex health and social service systems to improve outcomes.

Active, unrestricted LCSW or LISW license and 2+ years in medical or community social work are required, along with a

Qualifications

• Active, unrestricted license LCSW or LISW.
• 2+ years of medical, care management, or community social work experience.
• Valid driver's license and reliable transportation.

Responsibilities

• Conduct psychosocial, SDOH, caregiver, and behavioral health assessments
• Identify barriers to care and connect members to community resources and support services
• Develop and implement individualized care plans in collaboration with the interdisciplinary team
• Coordinate referrals for housing, food, transportation, utilities, caregiver support, and other community-based services
• Assist members with Medicaid, Medicare Savings Programs, Extra Help/LIS, and D-SNP eligibility and recertification
• Support care transitions and post-discharge planning to promote safe returns home and reduce readmissions
• Facilitate advance care planning and goals-of-care discussions
• Provide crisis intervention, elder abuse and neglect screening, and mandated reporting as required
• Build and maintain relationships with community organizations and ensure follow-through on referrals

Skills

Bilingual English/Spanish

Crisis intervention

Assessment and care planning

Education

LCSW or LISW license

Job description

UnitedHealth Group, operating through Optum in Albuquerque, is seeking a compassionate Social Worker to support high-risk members by addressing social determinants of health, behavioral health needs, and barriers to care. You will conduct psychosocial assessments, develop resource plans, and help members navigate complex health and social service systems to improve outcomes.

Active, unrestricted LCSW or LISW license and 2+ years in medical or community social work are required, along with a