Remote Social Worker: Care Coordination & Outcomes

Bon Secours Mercy Health; Virginia Beach (VA); On-site; USD 37,000 - 57,000; Full time

Benefits offered by this job

Competitive pay

Medical, dental, vision coverage

Paid time off

Tuition assistance

Job summary

Bon Secours Mercy Health is seeking a remote Social Worker to provide clinical care management for eligible patients across the Hampton Roads, VA region. You will coordinate care with the IDT, develop care plans, and address barriers to improve outcomes while reducing unnecessary costs.

You’ll perform comprehensive assessments, enroll patients in complex case management, and collaborate with PCPs, specialists, and hospitalists to ensure timely, patient-centered care and access to community

Qualifications

• Bachelor’s Degree (required)
• Bachelor’s or Master’s Degree in Social Work (preferred)
• Licensure as required by state of practice
• Case Management certification, LSW or LCSW (preferred)
• 2-3 years acute care, home health or case management experience
• Excellent interpersonal communication and negotiation skills.
• Strong analytical, data management and computer skills.
• Familiarity with Community Resources.
• Flexibility to work non-traditional hours.
• Works well in a Team Setting.
• Experience with database entry, EMR documentation, Power Point preferred and basic Excel skills.
• Highly organized and detail oriented.
• Accepts responsibility and follows through on projects and activities.

Responsibilities

• Maintain a caseload of patients.
• Identify, enroll and manage patients in Complex Case Management.
• Develop and implement care plans to maximize wellbeing and review updates.
• Collaborate with ACM, PCPs, Specialists, and Hospitalists on patient care plans.
• Assess social determinants of care and set goals in the care plan.
• Outreach and document in EMR according to protocols.
• Identify, referrals to care and community resources.
• Assist patient in advanced care planning and directives.
• Coordinate services for post-acute rehabilitation or long-term care.
• Advocate for patient needs and connect to resources.

Skills

Interpersonal communication

Negotiation skills

Data management

Computer skills

EMR documentation

PowerPoint

Excel

Team player

Community resources

Attention to detail

Organizational skills

Accountability

Education

Bachelor’s Degree

Social Work degree (BSW/MSW)

Tools

PowerPoint

Excel

Job description

Bon Secours Mercy Health is seeking a remote Social Worker to provide clinical care management for eligible patients across the Hampton Roads, VA region. You will coordinate care with the IDT, develop care plans, and address barriers to improve outcomes while reducing unnecessary costs.

You’ll perform comprehensive assessments, enroll patients in complex case management, and collaborate with PCPs, specialists, and hospitalists to ensure timely, patient-centered care and access to community