WorcesterRecruiter Since 2001
the smart solution for Worcester jobs

ACO Social Work Care Manager

Company: Fallon Community Health Plan
Location: Worcester
Posted on: November 22, 2020

Job Description:

ACO Social Work Care ManagerUS-MA-WorcesterJob ID: 6131Type: Full Time# of Openings: 1Category: Case ManagementFallon Health - Corp HQOverviewAbout Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief summary of purpose:

  • The ACO Social Work Care Manager (SWCM) works very closely with ACO Partners, Community Partners, and community based groups to address service gaps and serves as a liaison to social and health resources on behalf of Fallon Health and the Fallon Health ACO Model of Care.
  • The SWCM will collaborate and coordinate with State Agencies, DMH, DDS, DYS, DCF to ensure members care is efficient and coordinated.
  • The SWCM provides social service coordination services to ACO members as referred assessing member needs, services and resources to address social, health, or economic needs and facilitates referrals and collaboration with ACO Provider Care Teams and BH Partners in the community.
  • The SWCM assists the member and or family to provide care utilizing FH benefits and/or community resources developing a plan to coordinate a continuum of care consistent with the members' health care needs and/or goals.
  • The SWCM uses their knowledge of benefit plan design, eligibility and/or financing alternatives available within the community to provide options that meet member's needs.
  • The SWCM identifies services, care delivery settings, and funding arrangements that meet the needs of the members. He/She recommends alternatives where appropriate. The SWCM monitors services and provides consistent feedback to the team on progress.
  • The SWCM collaborates and works with members of the Care Team both at Fallon Health and at the ACO Partners during time of member transition of care. ResponsibilitiesACO Member Care Coordination and CollaborationProvides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs while completing program assessments and working with the Care Coordinator to ensure the member approves their care planMonitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member's health care goals and needsActively participates in internal clinical rounds and huddles Works with members of the Utilization Management Department assisting with difficult or complex care delivery or discharge planning needs for ACO members Actively participate with Beacon team and collaborate on high risk members to decrease utilization May collaborate with ACO staff on site to facilitate communication between Fallon and ACO teams Assists with care coordination with ACO Partners to engage in Interdisciplinary team meetings Works with Nurse Case Managers and Navigators to coordinate a continuum of care for ACO members consistent with the member's health care goals and needs Maintains an ongoing awareness of clinical, social, and financial resources available in the community as well as State/Federal and National Resources and connects and advocates for members as appropriate Performs other responsibilities as assigned by a member of the Clinical Integration Leadership Team
  • Participates in monthly supervision and one on one meetings with the managerQualificationsEducation:Master's degree from an accredited school of social work, mental health counseling, psychology, or human services required. License:Active, unrestricted license as a Licensed Independent Clinical Social Worker or Licensed Mental Health Counselor in Massachusetts; Reliable transportation required. Certification: Certification in Case Management strongly desired Experience:
    Four years of experience working with the following: the chronically ill, SPMI, and substance use populations required. Experience and comfort conducting face-to-face visits with members in the community and in home settings required.Experience working in a multi-disciplinary care team required.Experience working and providing collaborative care management interventions with various State Agencies such as DMH, DDS, DCF, DYS required.Experience working with provider groups such as medical and/or mental health providers required.Background working with all age groups preferred. Previous experience working at a Managed Care Organization preferred. Resources used in performing role:Microsoft products (Word, Excel, Visio, PowerPoint, Outlook); reporting software such as Business Objects; Boxer Application; CaseNET TruCare System; QNXT System, Provider EMRs as applicableOther:Satisfactory Criminal Offender Record Information (CORI) results.PM16 PI126000882

Keywords: Fallon Community Health Plan, Worcester , ACO Social Work Care Manager, Healthcare , Worcester, Massachusetts

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Clinical Nurse - Clinic (FT), Primary Care - Days
Description: Job Description: Purpose: The Clinical Nurse is an engaged and credentialed member of the Professional Nursing Organization and is responsible for autonomous practice directed by the professional tenets (more...)
Company: Dartmouth-Hitchcock
Location: Concord
Posted on: 11/30/2020

Physician / Psychiatry / New York / Locum tenens / Psychiatrist Job
Description: Facility in the Albany area is seeking a full time Psychiatrist to work a long term locum tenens assignment.
Company: FCS - Psychiatric Recruitment
Location: Troy
Posted on: 11/30/2020

Full Time Lead Licensed Practical/Vocational Nurse
Description: Addiction Medicine opening in Concord, New Hampshire. This and other lpn/lvn jobs brought to you by NursingJobCafe.com For over 30 years, New Season Treatment Centers have been a leading national health (more...)
Company: New Season
Location: Concord
Posted on: 11/30/2020


MICU Medical Intensive Care RN Travel Nurse
Description: Nationwide Travel Nurse Jobs - Medical Intensive Care RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified (more...)
Company: HealthCare Travelers
Location: Concord
Posted on: 11/30/2020

Pediatric's Travel Nurse (Peds RN)
Description: Travel Nurses Needed - Pediatric RN Specialties br Nationwide Pediatric Travel Nursing JobsPediatric Intensive Care Unit, Pediatrics, Pediatric OncologyHCEN has numerous request for RN Candidate Profiles (more...)
Company: RN Travel HealthCare Jobs
Location: Concord
Posted on: 11/30/2020

Medical Assistant II (FT), Primary Care - Days
Description: Job DescriptionPurpose: Responsible for clinical duties such as taking vital signs, giving injections, performing simple diagnostic tests, collecting specimens, drawing blood, sterilizing and cleaning (more...)
Company: Dartmouth-Hitchcock
Location: Concord
Posted on: 11/30/2020

ICU Trauma Unit Travel Nurse RN
Description: Nationwide Travel Nurse Jobs - Trauma ICU RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified registered (more...)
Company: HealthCare Travelers
Location: Concord
Posted on: 11/30/2020

Travel RN Crisis Rates - HealthCare Travelers
Description: Travel Nurses Needed - All RN SpecialtiesMassachusetts Travel Nursing AssignmentsHospitals are posting their seasonal staffing needs--Would you like to spend the fall / winter somewhere great The Hospitals (more...)
Company: HealthCare Travelers (Nursing)
Location: Concord
Posted on: 11/30/2020

Strategic Account Executive - Medical Device
Description: To get the best candidate experience, please consider applying for a maximum of 3 roles within 12 months to ensure you are not duplicating efforts. Job CategorySalesJob DetailsJob DescriptionAbout Salesforce (more...)
Company: Salesforce.com, Inc
Location: Concord
Posted on: 11/30/2020

RN Travel Nurse Cath Lab RN
Description: Nationwide Travel Nurse Jobs - Cath Lab RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified registered (more...)
Company: HealthCare Travelers
Location: Concord
Posted on: 11/30/2020

Log In or Create An Account

Get the latest Massachusetts jobs by following @recnetMA on Twitter!

Worcester RSS job feeds