Program Specialist - Social Worker

Job Title: Program Specialist Social Worker

Location: Remote in North Carolina

Duration: 10 Months (Extension)

Shift: Monday through Friday 8:00am to 5:00pm or 9:00am to 6:00pm Saturdays (alternating every other weekend) ***includes holidays

Job Summary:

• Conduct screening and risk assessment interventions per program guidelines.
• Candidate must reside in NC (North Carolina).
• Assist with nonmedical aspects of the members care including referrals to community resources.
• Walk me through the daytoday responsibilities of this the role and a description of the project (
• Healthy Opportunities (HOP) Eligibility & Enrollments Benefits Eligibility Screenings Cold Calls Assistance in phone queue

Productivity Expectations:

• HOPrelated tasks and correlating average processing times. Required to meet/exceed the minimum 6.5 hrs. of daily completed work.

Task

Average Processing Time

Assessments

< 20 minutes

Eligibility/Enrollments

< 30 minutes

Service Authorizations/Disenrollments

< 7 minutes

2day followups

< 5 minutes

Productivity logs should reflect 6.5 hrs. per day of completed work.

For example:

Task

Calculation

HH:MM

Eligibility/Enrollments

8x30/60

4

Assessments

6x20/60

2

2day followups

6x5/60

0.5

Total

6.5

Job Responsibilities:

• Healthy Opportunities (HOP) Eligibility & Enrollments Benefits Eligibility Screenings Cold Calls Assistance in phone queue.
• Identify special needs members through the completion of health screens and other resources.
• Collaborate with community outreach/member advocates to coordinate member care.
• Educate providers and community resources on program components and available support services.
• Educate members with special needs to foster compliance with program and positively impact outcomes.
• Conduct site visits as appropriate for programs and provide support to other special programs.
• Develop and modify care plans in conjunction with members members family and managing physician.
• Development of plan specific literature and education materials in conjunction with medical director and corporate oversight

Minimum Qualification:

• Bachelor/masters in social work.
• Proficient with excel/word.
• Experienced MSW/SW in a healthcare/community setting.
• Community work experience with closing SDoH needs.