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Case Management Social Worker, Bakersfield, CA


Organization: Kern Health Systems
Category: Social Worker
Location: Bakersfield, CA
Date Job Posted: December 29, 2021
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Case Management Social Worker

Kern Family Health Care, 2900 Buck Owens Blvd., Bakersfield, California, United States of America Req #1674

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).

Definition

Under the direction of the CM MSW Supervisor and the CM Manager, the Social Worker will plan and implement medical social service delivery programs, promote coordination, continuity of care, and quality management in support of KHS members. This position serves as a liaison to all KHS staff, providers, and members to provide any social service needs identified for KHS membership.

Distinguishing Characteristics

This position is responsible for assigned social work case management functions for KHS, a licensed health maintenance organization (HMO). The primary duty of the Social Worker is to identify and assist members that are displaying a complex variety of social and or emotional needs and usage of services reflective of abuse, lack of compliance to medical or pharmaceutical instructions, or self-destructive habits. The Social Worker coordinates with these members and the member’s PCP in an effort to provide better medical management and to track and gauge the effectiveness of that effort.

Essential Functions

  • Collaborate with staff members, community agencies and consultants to resolve the needs and problems of the member through the development of social service programs.
  • Establishes and maintains interpersonal relationships with both internal and external staff and other agencies.
  • Assists members and/or families/significant others, regarding discharge issues.
  • Coordinates discharge planning activities with facility discharge planners and KHS case managers and make appropriate referrals to community resources.
  • Keeps staff updated as to what resources are available and maintains and updates a statewide resource directory for a vast variety of social service needs.
  • Provides case management in conjunction with other case management staff and community providers in emergency and non-emergency situations.
  • Documents interactions with members and providers as required and maintains records of referral interactions with behavioral health carve-out vendor.
  • Supports other KHS departments in community initiatives.
  • Has the ability to independently assess the psychosocial functioning and needs of patients and their family members and to formulate and implement a treatment plan, identifying the patient's problems, strengths, weaknesses, coping skills and assistance needed, in collaboration with the patient, family and interdisciplinary treatment team.
  • Has knowledge and experience in the use of medical and mental health diagnoses, disabilities and treatment procedures. This includes acute, chronic and traumatic illnesses/injuries, common medications and their effects/side effects, and medical terminology.
  • Exhibits knowledge and skill in the use of computer software applications for drafting documents, data management, and tracking.
  • Possesses excellent written and verbal communication with contract providers and internal KHS staff to promote effective and timely coordination of care and dissemination of KHS policies and procedures.
  • Performs day-to-day administrative tasks such as maintaining information files and processing paperwork i.e. manage detailed case records in a social work setting and process medical records
  • Coordinates services between Case Managers and all other KHS Internal departments as well as the Executive and Management teams in developing member action plans, follow-up activities and corrective actions to address the identified needs for the member.
  • Functions at a highly skilled level in such areas as counseling, medical social work, protective services, family services, community organization and research.
  • Identifies environmental impediments to client or patient progress through both personal or telephonic interviews and review of medical records.
  • Assesses each member's medical and social history to determine specific needs, identify goals and support system availability.
  • Investigates suspected child/elder abuse or neglect cases and notify authorized protective agencies when necessary.
  • Refers member to community resources to assist in recovery from mental or physical illness and to provide access to services such as financial assistance, legal aid, housing, or education.
  • Advocates for members to resolve crises and demonstrate proficiency in de-escalation and interventional techniques.
  • Identifies strategies to address identified social problems, substance abuse prevention, or facilitate referrals to community health and counseling services.
  • Utilizes consultation data and social work experience to plan and coordinate member care and rehabilitation, following through to ensure service efficacy.
  • Assists in the collection of documentation if determined through investigation of member’s behavior or referral patterns that member is in violation of KHS policy and will be removed from the plan and coordinate filings with the appropriate governing agency.
  • Conducts social research to advance knowledge in the social work field Assists in identification of members needing disease management services and making appropriate referrals to the Disease Management Program.
  • Collaborates with the KHS Member Services Department and the Provider Relations Department regarding quality of care and other grievance issues in order to facilitate timely problem resolution.
  • Serves as an internal representative to contract providers to promote appropriate and timely case management to KHS members.

Other Functions

  • Performs other job-related duties as required.
  • Occasional travel required.
  • Adheres to KHS’s Code of Ethics and Business Conduct and all company policies; e.g., confidentiality, attendance, safety/security, use of equipment and technology, appearance and demeanor.

Employment Standards

Education: Master of Social Work degree from an accredited college/university required. LCSW preferred.

Experience: Two (2) years of experience in the Social Worker field, preferably a background in the medical social work. Demonstrated experience in social work including interviews, assessments, problem identification/resolution, appropriate documentation and crisis intervention.

Must have: Excellent written, verbal and interpersonal communication skills required. Applicants should be able to demonstrate knowledge and experience of managed care systems. Have demonstrated skills in coordination and problem solving with members and providers.

Other Requirements: Possession of valid driver’s license and proof of State required auto liability insurance. Required Travel Up to 5%

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

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