Social Worker MSW Care Manager Health Plan
Social Worker MSW Care Manager Health Plan
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Salary Not Disclosed
1 Vacancy
Job Description
About Priority Health
We are the second largest and fastest growing health plan in Michigan focused on improving the health and lives across the state and we couldnt do it without the incredible talent of our employees. It is their commitment that continues to drive our success as a nationally recognized nonprofit health benefits company. As part of the Corewell Health system our team members have a unique ability to grow and advance their career while maintaining their seniority and benefits.
Scope of work
Plans and prioritizes care for individuals and population of patients focusing on strategies that will promote optimal health within populations. Demonstrates expertise current knowledge in care and management of a caseload of members of varying complexity and seeks to improve member family and health systems / community outcomes through the application of educational concepts / skills and preventive care in a managed care environment. Collaborate with providers community organizations and systems to coordinate care and ensure members and their families are connected to the resources needed to promote health and wellbeing and advocate and address any barriers to access needed services.
Develops and prioritizes plans to meet needs and provides services. Follow up with families and community agencies to evaluate effectiveness of services provided and plan for future needs.
Develops plan of care and makes recommendations to PCPs specialists and other members of the health care team regarding care management strategies identifying strategies to maximize continuity of care across the continuum.
Assess internal and external referrals to meet identified member and their familys needs level of intensity mandated reporting referrals insurance benefits and other member resources.
Communicates and collaborates with member/significant others/providers/payers to coordinate services that improve access to appropriate services across the continuum of care and which promotes optimal health in a cost-effective manner.
Measure member care outcomes interprets reports and analyzes data trends for groups of members.
Documents member data plan interventions and outcomes according to department guidelines.
Ensures processes and services are continuously monitored for quality cost effectiveness and efficiency Engages in process and quality improvement activities. Makes and implements recommendations to improve operational efficiency and to implement new services for areas of responsibility
Assesses the educational needs of members families and members of the health care team and develops and implements appropriate teaching strategies or makes referrals. Maintains knowledge of current trends and developments in the field
Qualifications
Required Masters Degree Social work
5 years of relevant experience LMSW - clinical and/or case management/managed care or related field Required
Master Social Worker (MSW-Master) - State of Michigan Upon Hire required
How Corewell Health cares for you
Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!
Optional identity theft protection home and auto insurance pet insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Priority Health - 1231 E Beltline - Grand RapidsDepartment Name
PH - Care Management - DSNPEmployment Type
Full timeShift
Day (United States of America)Weekly Scheduled Hours
40Hours of Work
8:00 a.m. to 4:30 p.m.Days Worked
Monday to FridayWeekend Frequency
N/ACURRENT COREWELL HEALTH TEAM MEMBERS Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.
An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
Required Experience:
Manager
Employment Type
Full-Time
