Social Worker at Blue Cross Blue Shield of Michigan Mutual Insurance Company

SUMMARY: 

Support the overall improvement of member’s health status in collaboration with the case managers and physicians by identifying and referring members to community resources, counseling and/or support services. Educate patients about entitlement programs, legal issues or other services relevant to social work practice skills and knowledge. 

RESPONSIBILITIES/TASKS:

 • Develop, coordinate and evaluate a social worker assessment for identified members. • Consult and coordinate with the case manager and physician to identify member issues and develop a plan to resolve the issues 

• Assess the members’ progress to social work intervention and community services provided through on site visits and POD review sessions upon invitation 

• Assist the Case Manager with psychosocial needs assessment and identification of appropriate resources.

 • Identify and refer members to community resources, counseling, and/or support for the member and/or authorized representative, as needed

 • Document all activities as appropriate, including but not limited to member assessment, communication with case managers, PCP or issues related to guardianship, abuse/neglect.

 • Educate the member and/or authorized representative about entitlement programs (i.e., Medicaid, Social Security), legal issues (i.e. guardianship, advanced directives) and assisting in the application process as needed

 • Assist the member and/or authorized representative with long-term care planning and of end of life decisions and options as needed

• Provide member receiving hospice services with information regarding appropriate community resources.

 • Travel may be required (Detroit).

This is a remote position

EMPLOYMENT QUALIFICATIONS: 

EDUCATION: 

• Master’s degree in social work required.
• Current unrestricted Licensed Master’s Social Worker Certification in Case Management (CCM) preferred Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE: 

• Minimum of five (5) years of board medical social work experience required.
• Minimum of two (2) year to be in home health care and/or medical case management preferred

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: 

• Knowledge of clinical programs and P&P, HIPAA regulations and guidelines, American Disability Act, and clinical ethics
• Motivational interviewing skills as well as experience in performing assessments and interventions 
• Knowledge of Medical Policy, Care Management and Disease Management principles and alternate levels of care
• Basic computer applications/Microsoft word/typing required
• Ability to engage and motivate the member or member representative, mentor and train 
• Identify existing and or potential psychosocial and quality of care issues 
• Interact and collaborate with multidisciplinary team while advocating on member’s behalf
• Providing effective written and verbal communication/feedback
• Organizational skills and ability to prioritize and have a flexible work schedule