Medical Management Social Worker II
HCSC
 Richardson, TX

Job ID: RHB-1035608

Description:

  • After training, this will be a work from home position with the candidate living within a commutable distance from Richardson, Texas only*

We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits.

We're also tackling the social determinants of health by creating non-clinical partnerships in the communities where we work and live, because everyone should have access to quality health care. We use innovative tools and approaches to help members get the most out of their plan benefits, as affordably as possible. We are more than a health care insurer and we are truly anchored in our purpose: to do everything in our power to stand by our members in sickness and in health.

BASIC FUNCTION:

This position is responsible for working with members, member families and physicians on health issues including complex cases. Will assist the member and/or their family by identifying resource needs, including but not limited to financial, transportation and/or helping with locating support groups, as applicable. Evaluate the psychosocial and emotional needs of members with ongoing and/or situational medical concerns through coaching, education, and support for low acuity emotional needs. Coordinating referrals for behavioral health services when their emotional/mental health needs are more chronic in nature. Will assist the member in both inpatient or outpatient settings and will provide discharge planning assistance, as appropriate, during an inpatient stay. May travel to members home-settings to evaluate or coordinate treatment needs.

JOB REQUIREMENTS:

  • Master Degree in one of the following Behavioral Health areas: Social Work, Psychology, Human Services, with current unrestricted clinical license/certification in good standing in the state(s) of operation. (LMSW)
  • 1 year of utilization management, discharge planning or managed care experience.
  • Customer service oriented.
  • PC proficiency to include Word, Excel, and database experience.
  • Current valid drivers license and transportation .
  • Verbal and written communication skills.
  • Ability to remain at a work station and perform computer entry for long periods of time, as required.
  • Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management.

PREFERRED JOB REQUIREMENTS:

  • 2 years experience of direct clinical care to the consumer
  • 2 years of utilization management, discharge planning or managed care experience
  • 3 years of clinical practice experience, complex case management
  • Certified Case Management credentialing and /or ACM certification
  • Familiarity with ancillary services including Home Health Care (HHC) or Skilled Nursing Facility (SNF).
  • Bilingual in English/Spanish

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements:

Expertise Behavioral Health Job Type Full-Time Regular Location TX - Richardson