Care Manager - Social Work

About the job Care Manager - Social Work Required skills & experience Masters Degree in Social Work, behavioral sciences, or another related field. Currently licensed as an LCSW or LMSW in the State of MA 2+ years of previous experience working in care management and/or with chronic illness within a medical environment in home health or hospice. Ability to take calls remotely on some nights and weekends. Self-starter with the ability to work independently with minimal supervision. What You Need to Know: Opportunity to work in a dynamic, fast-paced, and innovative care management company that is transforming the delivery of kidney care. Competitive compensation package. Flexible paid leave and vacation policy. This is a full-time position in Home Health with frequent travel Laptop, mileage reimbursement, phone allowance, and extra perks are available! Additional Job Details: This position works within a 2-hour travel radius. Rare domestic travel may be required to Nashville, TN Self-starter with the ability to work independently with minimal supervision Ability to show empathy and quickly build relationships with patients and local CBOs Perform in-home care management visits to assess and impact the social and behavioral status Work closely with Care Team to ensure continual progress on all care management goals Assess social determinants of health needs and develop a plan for addressing them Perform behavioral, environmental, and social support assessments and surveys as needed Deliver individual, family, and group education on living with chronic illness Engage family and social support groups in the education and care of patients Assess patients and refer them to behavioral health specialists if diagnosis and treatment needed Help patients understand, accept and follow medical and lifestyle recommendations Serve as the point of contact for patient questions regarding social and behavioral Facilitate conversations around and consideration of proactive care decisions, especially relating to transplantation, home modalities, and AV fistula placement Initiate patient relationships through enrollment and onboarding processes Review and document patient updates and progress in the care management platform Identify, vet, and build relationships with local Community-Based Organizations Introduce patients to appropriate resources and act as the patient advocate Serve as subject matter expert on social determinants for other members of the Care Team The work schedule is Monday Friday 8 am 5 pm. However, there could be exceptions where a patient does request a visit after 5 pm. #J-18808-Ljbffr