Responsibilities:
- Coordinate team work flows with community outreach and member advocates to coordinate member care
- Ensure and maintain compliance with federal and state regulations and contractual agreements
- Oversee and conduct site visits as appropriate for programs and provide support to other special programs
- Review and modify care plans in conjunction with member, member’s family and managing physician
- Oversee the development of plan specific literature and education materials in conjunction with medical director and corporate oversight
- 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
- Oversee all screening and risk assessment interventions per program guidelines, and manage all non-medical aspects of the member’s care, including referrals to community resources
Education/Experience:
- Bachelor’s degree in Social Work, Nursing, Health, Behavioral Science or equivalent experience
- 5+ years of community experience in directly managing and integrating the social/community needs of members
- Experience managed care environment or working with people with disabilities and vulnerable populations who have chronic and complex conditions
- Master’s degree in social work preferred
- Previous experience as a supervisor or lead in a functional area or managing cross functional teams on large scale projects preferred
License/Certification:
- Current state driver’s license (not required for Indiana)
- RN (Registered Nurse), LCSW (Licensed Certified Social Worker), LPN (Licensed Practical Nurse), Occupational Therapy (OT), Physical Therapy (PT), or LVN (Licensed Vocational Nurse) preferred