Degreed Social Worker - Health Plan
Apply NowCompany: TotalMed
Location: Winnebago, IL 61088
Description:
Degreed Social Worker-Health Plan
Job ID #1770207
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About this Role
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
Job details
$40.83 / hour
McHenry/Winnebago Counties, Illinois
New
Profession: Degreed Social Worker
Facility Type: ???
Specialty: Health Plan
Division: MedFi
Start Date: 03/10/2025
Apply
Responsibilities
Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility
Coordinates and implements assigned care plan activities and monitors care plan progress.
Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs
Identifies and escalates quality of care issues through established channels
Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Helps member actively and knowledgably participate with their provider in healthcare decision-making.
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
Case management experience preferred
2 years experience in behavioral health, social services or appropriate related field equivalent to program focus
Managed Care experience preferred
Bachelor's degree in behavioral health or human services REQUIRED (psychology, social work, marriage and family therapy, nursing, counseling, etc.) or non-licensed masters-level clinician.
Job ID #1770207
| Share
About this Role
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
Job details
$40.83 / hour
McHenry/Winnebago Counties, Illinois
New
Profession: Degreed Social Worker
Facility Type: ???
Specialty: Health Plan
Division: MedFi
Start Date: 03/10/2025
Apply
Responsibilities
Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility
Coordinates and implements assigned care plan activities and monitors care plan progress.
Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs
Identifies and escalates quality of care issues through established channels
Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Helps member actively and knowledgably participate with their provider in healthcare decision-making.
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
Case management experience preferred
2 years experience in behavioral health, social services or appropriate related field equivalent to program focus
Managed Care experience preferred
Bachelor's degree in behavioral health or human services REQUIRED (psychology, social work, marriage and family therapy, nursing, counseling, etc.) or non-licensed masters-level clinician.