Social Work Care Manager

The Social Work Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The care manager advocates for and supports member care management needs by providing professional social work services and care management while coordinating benefits and resources.

Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

• Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health
• Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies
• Screen candidates for management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines
• Update care plan to reflect progress towards goals; close cases when expected goals/outcomes are achieved
• Provide information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
• Evaluate and process member referrals from physicians to other specialty providers
• Assess, plan, facilitate and advocate for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
• Work with members and families on self-management approaches using coaching techniques such as motivational interviewing
• Educate the individual, his/her family and caretakers about case and condition management, the individual's health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes
• Facilitate the coordination, communication and collaboration of the individual's care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality
• Schedule visits with the individual and participate in facility-based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning
• Stay abreast of current best practices and new developments
• Other duties as assigned

Job Requirements:

• Bachelors Degree in Social Work, or related field
• Four years work experience as a Social Worker or Case Manager
• Experience with Medicare, Medicaid, Managed Care, and state and federal regulations pertaining to skilled nursing preferred
• Position may require two (2) years experience working in behavioral health
• Current licensure in the State of Wisconsin as a Certified Social Worker
• CAPSW, CISW preferred
• Proficient skill with MS Office products (Word, Excel, Outlook)
• Knowledge of case management principles, healthcare management and reimbursement systems
• Knowledge of behavior change theory/motivational interviewing

** This position is eligible to work out of your home office in the state of Wisconsin. Travel to the corporate office will be required occasionally for the position.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.