Social Work Care Manager

Blue Cross And Blue Shield Of Alabama - Tuscaloosa, AL

Full-time

Tuscaloosa, AL

Insurance Carriers and Related Activities

About the position

The Social Work Care Manager is responsible for coordinating care for individuals with various health needs, including those with chronic conditions and pregnant women. The role focuses on improving the quality of care programs and community outreach for low-income populations. This position involves conducting assessments, developing care plans, and collaborating with healthcare providers to enhance patient outcomes.

Responsibilities

• Conduct facility, practice, and home visits to complete screenings and assessments for assigned recipients.
• Manage recipients not receiving transitional services.
• Consult with the Multidisciplinary Care Team (MCT) to develop and implement patient-centered holistic care plans.
• Collaborate with medical, behavioral health, and community resource providers to create effective care plans.
• Promote quality assurance to improve recipients' health outcomes.
• Support recipients transitioning between care settings by managing their social needs and appointments.
• Ensure timely assignment and completion of care management tasks.
• Comply with state performance metrics and goals.
• Reduce inappropriate utilization and costs associated with emergency department and hospital services.
• Support staff and Primary Care Providers (PCPs) in providing appropriate services to clients.
• Meet AlaHealth and Medicaid requirements for charting and audits.

Requirements

• Bachelor's degree in Social Work (BSW) or Master's degree in Social Work (MSW).
• Active Alabama license as a Licensed Baccalaureate Social Worker (LBSW).
• Strong verbal and written communication skills.
• Ability to document electronic case records effectively.
• Experience managing a heavy caseload.
• Experience analyzing clinical situations and making informed decisions.
• Experience in written, verbal, and interpersonal communications.
• Experience working with medical providers and community resource agencies.
• Willingness to travel as required for the job.

Nice-to-haves

• Two years of complex pediatric experience preferred.
• Experience working in a home setting as a Case Manager or Care Coordinator preferred.
• Knowledge of Alabama Medicaid regulations and guidelines preferred.
• Knowledge of community-based agencies and resources preferred.