Senior Clinical Social Work Care Manager

EmblemHealth; New York (NY); On-site; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth in New York, NY seeks an experienced Care Manager to oversee comprehensive management for members with chronic or catastrophic illness, frail elderly, or psychosocially complex conditions. You will coordinate care across settings, engaging members, families, and providers to ensure appropriate services and transitions.

The role requires a LMSW with 4–6+ years in case management, knowledge of Medicare/Medicaid regulations, and strong communication and organizational skills.

Qualifications

• Bachelor's degree is required.
• Masters' in social work (LMSW) is required.
• Certification in clinical social work (LCSW) preferred.
• 4-6+ years' case management and/or managed care experience.
• Knowledge of Federal and State regulations for Medicare and Medicaid and other national and state funded programs.
• Knowledge of community resources access.
• Proven track record in leading care management teams.
• Health plan experience.
• Excellent communication skills (verbal, written, presentation, interpersonal).
• Proficient with MS Office (Word, Excel, PowerPoint, Teams, Outlook, etc.).

Responsibilities

• Develop, facilitate, and communicate a plan of care in partnership with the member and caregivers.
• Provide care management through assessment, planning, implementation, coordination, monitoring, and evaluation.
• Assist members with coordination of services from various settings; facilitate discharge to home or alternate settings.
• Assess members to determine suitability for management early in disease progression.
• Assess Social Determinants of Health and mental health needs.
• Provide mental health counseling referrals and support as needed.
• Optimize quality of care and life; identify members for specialty programs.

Skills

Excellent communication

Problem solving

MS Office

Detail oriented

Organized

Education

Bachelor's degree

Masters in social work (LMSW)

LCSW certification preferred

Tools

MS Office

Job description

EmblemHealth in New York, NY seeks an experienced Care Manager to oversee comprehensive management for members with chronic or catastrophic illness, frail elderly, or psychosocially complex conditions. You will coordinate care across settings, engaging members, families, and providers to ensure appropriate services and transitions.

The role requires a LMSW with 4–6+ years in case management, knowledge of Medicare/Medicaid regulations, and strong communication and organizational skills.