Social Worker Care Coordination - Population Health

Bon Secours Health System; Rock Hill (SC); Remote; USD 50,000 - 70,000; Full time

Job summary

A healthcare organization is seeking a Social Worker for a remote position in South Carolina. The role involves providing clinical care management services, developing comprehensive care plans, and collaborating with a team to improve patient outcomes. Candidates should have relevant qualifications and experience in case management. Competitive pay and benefits are provided.

Benefits

Competitive pay

Medical, dental, vision coverage

Paid time off

Tuition assistance

Qualifications

• 2-3 years of experience in acute care, home health, or case management.
• Licensure as required by state for practice.
• Case Management certification preferred.

Responsibilities

• Maintain a caseload of patients according to department policies.
• Develop and implement care plans.
• Perform assessments of social determinants of care.

Skills

Interpersonal communication skills

Data management skills

Organizational skills

Education

Bachelor's Degree in Social Work

Master's Degree in Social Work

Tools

Electronic medical record documentation

Database entry

Excel

Job description

Thank you for considering a career at Bon Secours Mercy Health!

Scheduled Weekly Hours: 40

Work Shift: Days (United States of America)

Summary of Primary Function/General Purpose of Position

In the capacity of a Social Worker, provide clinical care management services to identified eligible patients, coordinating care to obtain desired health outcomes, improve self-care abilities, and decrease unnecessary cost of care. Work as a member of Interdisciplinary Team (IDT) along with the Ambulatory Care Manager (ACM) and Care Coordinator to ensure the assigned patient’s individual needs are identified and addressed in a timely manner. Perform standardized comprehensive needs assessment, identifying and addressing barriers to care and aligning patients with available benefits and resources.

This is a remote/work from home position, but hire must be familiar with the region and communities he/she/they will support in South Carolina.

Florence, SC is the primary market- extending to Cheraw, Manning, Dillon, Loris, Little River, and Myrtle Beach.

Essential Job Functions

• Maintain a caseload of patients according to department policies.
• Identify, enroll and manage patients in program for Complex Case Management.
• Develop and implement care plans to maximize wellbeing with periodic review and update according to department protocols.
• Collaborate with ACM, PCPs, Specialists, and Hospitalists to effectively implement a patient-centered care plan.
• Perform situational and family assessment of social determinants of care and develop goals as part of the comprehensive care plan.
• Perform patient outreach according to established protocols and document in electronic medical record.
• Identify, execute, and track needed referrals to care and community resources.
• Provide resource management to improve care, patient experience and reduce unnecessary cost and utilization: right care, right place, and right time.
• Assist patient in advanced care planning to complete Advanced Directives.
• Document all communications with patient and/or care team in electronic medical record.
• Perform coordination of services for disabled status and/or facilitate placement in post-acute facility for rehabilitation or long term care.
• Act as patient advocate to address primary physical and socioeconomic needs and link patient to appropriate community resources and services.

Employment Qualifications

Education Qualifications

Bachelor’s Degree (required)

Bachelor’s or Master’s Degree in Social Work (preferred)

Licensing/ Certification

Master’s Degree or Licensure as required by state of practice (required)

Case Management certification, LSW or LCSW (preferred)

Minimum Qualifications

Minimum Years and Type of Experience: 2-3 years acute care, home health or case management experience

Other Knowledge, Skills and Abilities Required

Excellent interpersonal communication and negotiation skills. Strong analytical, data management and computer skills. Demonstrate basic knowledge of healthcare and health education across the lifespan in a practice health setting. Ability to work with individuals, groups and families. Familiarity and knowledge of Community Resources. Flexibility to work non-traditional hours. Works well in a Team Setting. Personal computer skills. 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

Other Knowledge, Skills and Abilities Preferred

Demonstrated success in improving the health of a distinct population of patients in the ambulatory or community setting

Bon Secours Mercy Health is an equal opportunity employer.

As a Bon Secours Mercy Health associate, you’re part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
• Paid time off, parental and FMLA leave, shot- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Bon Secours Mercy Health is committed to providing equal employment opportunities to all applicants and employees without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability.