The Special Needs Program (SNP) regional team social worker is responsible for reviewing Peoples Health regional team assessment(s) to ensure that services and communications are designed and executed in a manner, which results in improved quality of health for members.
The SNP Regional Team Social Worker ensures that every dual-eligible member on their regional team has an individual care plan (ICP) that is reviewed and approved by the Inter-disciplinary Care Team (ICT) on an annual basis. The SNP Social Worker will serve as a member of the ICT, review Peoples Health databases to ensure that assessment(s) and ICP(s) document problems, goals and interventions (PGI) and assist in preparation of ICT meeting agenda and follow-up to referrals from the ICT.
Coordinates ICP review for ICT
Reviews daily census, enrollment reports and databases (CCMS) reports to identify members who need an ICT review
Research and review member claims history for creation of ICP
Requests and performs review of member medical records from Providers to create ICP when member is unable to be reached
Reviews assessments for significant changes n ICP and prepares notes for ICT for review
Interfaces with regional team and interdisciplinary Care Team in coordinating member needs and goals
Provides education to members to promote adherence to ICP when requested by ICT
Generates referrals to the appropriate discipline in order to provide appropriate services/programs when requested by ICP
Master of Social Worker degree from an accredited graduate program required. CSW, with graduate work experience in a healthcare setting, or LMSW required. LCSW or LCSW eligible (currently under supervision) with a minimum of professional work exposure or graduate field practicum in either medical social work, Medicaid/Medicare populations or mental health tracks highly preferred. Strong problem solving skills and organizational skills required. Excellent oral and written communication skills needed.
Must be able to handle multiple demands of diverse workload and prioritize critical issues. Must be able to work independently, as well as a member of a team and must be able to manage time appropriately. Experience working with computer programs including Word and Outlook also required.
Peoples Health, Inc. - 2 years ago
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