Social Worker - Care Coordination & Advocacy

UnitedHealth Group; Harlingen (TX); On-site; USD 50,000 - 89,000; Full time

Job summary

WellMed, part of UnitedHealth Group, seeks a Social Worker to assess and coordinate services for patients in its health plan. The role involves evaluating complex cases, connecting with physicians and care teams, and advocating for patients throughout the care continuum.

You will perform home and clinic assessments, ensure plan eligibility compliance, and participate in interdisciplinary team meetings. A Bachelor of Social Work and clinical readiness are required, with residency in Texas

Qualifications

• Bachelor of Social Work required with 3+ years' experience beyond required years
• Current BLS certification or must obtain within 30 days of hire
• 3+ years social work experience in a health care setting
• Proficient in MS Office to include Word, Excel, Notes, Outlook
• Reliable transportation for daily travel to various locations
• Valid driver's license in the state of work

Responsibilities

• Perform comprehensive evaluations and document findings per CMS standards
• Conduct patient assessments in home, clinic, hospital, or SNF
• Coordinate services within patient plan eligibility using federal/state resources
• Collaborate with external/internal teams to improve patient and provider satisfaction
• Engage in Performance Improvement initiatives and IDT meetings
• Maintain licensure, certifications and annual training and knowledge of health plan benefits
• Perform other duties as assigned

Skills

MS Office Suite

Valid driver's license

Reliable transportation

Communication skills

Education

Bachelor of Social Work

Master of Social Work (preferred)

Tools

Notes

Job description

Explore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together.

The Social Worker is responsible for the assessment, planning, coordination and oversight of services for identified patients' within their respective healthcare plan. The position identifies, evaluates, and provides management of services for patients with complex, catastrophic, SDOH (Social Determinants of Health) and/or psychosocial issues to promote quality, effective outcomes throughout the care continuum. The position ensures compliance with state and federal health plan requirements, Medicare guidelines and standards. Acts as a liaison to coordinate and collaborate care with physicians, family, and other providers while always remaining an advocate for patients, putting them at the center of care delivery. The Social Worker will interact and engage with others as an interdisciplinary team member.

Primary Responsibilities:

• Perform comprehensive evaluations and document findings in a concise/comprehensive manner that is compliant with documentation standards for the Center for Medicare and Medicaid Services (CMS)
• Performs patient assessments in multiple settings to include but not limited to the patient's home, the PCP/specialists clinic, hospital, and/or skilled nursing facility as needed
• Understands and plans to assure services provided work within the boundaries of the patient's plan eligibility. Coordinates identified patient's needs utilizing federal, state, and local community resources, as available
• Coordinates with external and internal teams to minimize obstacles and increase in patient and provider satisfaction
  • Active participation in Performance Improvement (PI) or regional strategic initiatives
  • Active participation in staff and Interdisciplinary Teams (IDT) meetings
  • Adheres to organizational and departmental policies and procedures
  • Maintains a high level of professionalism and adheres to the WellMed Core Values
• Assumes responsibility for personal and professional development
  • Ensures licensure, certifications, and annual training are maintained and compliant
  • Maintains knowledge of current health plan benefits
• Performs other duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Bachelor of Social Work with a minimum of 3 years' experience beyond the required years of experience
• Current BLS certification or must obtain certification within 30 days of employment hire date
• 3+ years social work experience in a health care environment
• Proficient in MS Office Suite to include Word, Excel, Notes, Outlook, and other departmental specific programs/applications
• Reliable transportation for daily travel to various locations as assigned
• Have a valid drivers license within the state of work

Preferred Qualifications:

• Masters of Social Work with licensure (LMSW or LCSW or LBSW)
• Knowledge of disease management, managed care, medical terminology, referral process, claims, and CPT coding
• Experience working with geriatric and behavioral and mental health patient populations
• Long Term Care experience
• Bilingual (English/Spanish) language proficiency
• Able to prioritize, plan, and handle multiple tasks/demands simultaneously
• Excellent oral and written communications skills
• Solid organizational skills

Physical & Mental Requirements:

• Ability to lift to 10 pounds
• Ability to push or pull heavy objects using up to 25 pounds of force
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to properly drive and operate a company vehicle
• Ability to receive and comprehend instructions verbally and/or in writing

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $49,700 to $88,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.