Social Worker Care Manager I

Kids Are Our Everything.   Department 10514 HSCSN - Care Management   Pay Range $65,124.80 - $108,555.20     Under the direction of the Supervisory Care Manager, the Care Manager I (CMI) is responsible for providing comprehensive care coordination services to members who are enrolled in the Health Services for Children with Special Needs (HSCSN) health plan. The CMI routinely communicates with members on their assigned caseload to assess their needs; develop, monitor and evaluate treatment plan progress; and assist with coordinating care and referring to appropriate services for members who have moderate to complex medical and psychosocial needs.   Minimum Education Master's Degree (Required) Minimum Work Experience 2 years Two or more years of healthcare or related experience in managed care and /or care management (Preferred) 2 years Two or more years experience in clinical or community resource settings (Preferred) Required Skills/Knowledge Effective verbal and written communication skills Bilingual (Spanish speaking) preferred Familiar with medical terminology Proficiency with computer systems and applications, particularly in Microsoft Office suite Strong organizational skills Ability to interpret and apply departmental requirements Ability to make sound decisions and use good judgment Ability to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service Ability to participate in professional, multidisciplinary meetings to include internal and external staff meetings Required Licenses and Certifications Graduate Social Worker Licensed in DC as a Licensed Graduate Social Worker (LGSW) (Required) Certified Case Manager (Preferred) Job Functions Manages a caseload as outlined by CASSIP and Care Management Leadership. Maintains compliance in accordance with contractual and care management requirements Contacts enrollee at predetermined intervals based on stratification level or more frequently, as needed. Conducts face-to-face visits at a frequency determined by the enrollee’s assigned stratification level or more if needed, with each enrollee/caregiver in their homes, physician’s offices, or other mutually agreed upon locations. Assesses enrollees on enrollment and at intervals determined by the enrollee’s stratification level to identify needs/barriers and close gaps in care. Identifies over/under utilization promptly, and takes appropriate action according to organizational policy. Upon gathering health and mental/behavioral health, environmental, psychosocial and educational information, the CM develops, implements, and updates an accurate individualized comprehensive care plan for each assigned enrollee in collaboration with the PCP and/or other multi-disciplinary team members including public agencies. Completes routine care coordination and care management activities with attention to quality, timeliness and in compliance with company policy and national…