Social Work Care Manager

Blue Cross And Blue Shield Of Alabama - Montgomery, AL

Full-time - Mid Level

Montgomery, AL

Insurance Carriers and Related Activities

About the position

The Social Work Care Manager at Blue Cross and Blue Shield of Alabama is responsible for coordinating care for individuals with various health needs, including those with chronic conditions and pregnant women. The role focuses on ensuring effective delivery of care through assessments, care plan development, and collaboration with healthcare providers. This position requires fieldwork, involving daily travel to support members in their local area, particularly in the Central region of Alabama.

Responsibilities

• Conduct facility, practice, and home visits on assigned recipients to complete screenings and assessments.
• 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 care plans.
• Promote quality assurance to improve health outcomes for recipients or clients.
• Support recipients transitioning between care settings by managing 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 of Science in Social Work (BSW) or Master of Social Work (MSW).
• Active Alabama license in good standing as a Licensed Baccalaureate Social Worker (LBSW).
• Strong verbal and written communication skills.
• Ability to document electronic case records and write effective care plans.
• Experience managing a heavy caseload.
• Experience analyzing clinical situations and making informed decisions.
• 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.

Benefits

• Full-time position with competitive salary.
• Opportunities for professional development and training.