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Social Worker - Behavioral Health

72% Flex
Remote: 
Full Remote
Contract: 
Salary: 
62 - 99K yearly
Experience: 
Senior (5-10 years)
Work from: 

Offer summary

Qualifications:

LCSW, LCMHC with 3 years experience, Master's in Social Work with 5 years experience may be considered, Valid and applicable clinical license required, Specialty certification may be needed.

Key responsabilities:

  • Coordinate care, resources for member populations
  • Perform comprehensive assessments and develop plans
  • Educate members on proactive intervention strategies
  • Evaluate and facilitate care through continuum of services
  • Document all aspects of the plan effectively
Blue Cross NC logo
Blue Cross NC Insurance XLarge https://www.bluecrossnc.com/
5001 - 10000 Employees
See more Blue Cross NC offers

Job description

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Job Description

In the role of Social Worker - Behavioral Health, your clinical expertise will be needed to coordinate appropriate care, resources, and services for specific member populations as a Case Manager/Health Coach. You will provide guidance and encourage effective utilization and monitoring of healthcare resources to ensure quality care for our members. Collaboration with various healthcare team members will be necessary to achieve optimal clinical and resource outcomes

  • Serve as a team member on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes. 
  • Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning.
  • Develop a member-centric plan tailored to members’ needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care.
  • Utilize community resources and funding sources as needed in the development of the plan of care.
  • Perform ongoing monitoring and management of member which may include scheduled follow-up with member, discussion of plan with member, appropriate services/education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plan/goals as needed, with contact frequency appropriate to member acuity.
  • Evaluate and facilitate care provided to members through the continuum of care (physician office, hospital, rehabilitation unit, skilled nursing facility, home care, etc).
  • Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes.
  • Effectively document all aspects of the plan from the initial assessment, development of the plan, implementation, monitoring, and evaluating outcome.  
  • May outreach directly to members identified as high risk, high cost, or high utilization cases.
  • May review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options, where eligible.
  • May evaluate medical necessity and appropriateness of services as defined by department.
  • As needed, develop relevant policies/procedures, education or training for use both internally and externally.

Hiring Requirements

  • LCSW, LCMHC with 3 years of clinical and/or case management experience required. For some roles a Master's in Social Work with 5 years of related experience may be considered.
  • For Behavioral Health specific roles, other applicable licensure may be considered with a minimum of 3 years of clinical experience.
  • Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties.
  • For some roles, additional specialty certification (i.e. CCM, CDCES) may be required.  If so, incumbents must obtain relevant certification within 2 years of employment.

Preferred Skills

  • Experience with Behavioral Health Case Management 
  • Experience working with interdisciplinary team
  • Available to work M-F between the hours of 8a-8p EST, rotating, as needed. 

Salary Range

$61,900.00 - $99,000.00

Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Soft Skills

  • Interpersonal Skills
  • Empathy
  • Teamwork
  • Team Collaboration
  • Proactivity

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