Senior Clinical Social Care Specialist

Role Type: Senior Clinical Social Care Specialist Reports To: Senior Clinical Social Care Manager Type: Full-Time, Permanent Location: Hybrid Salary: 58,000 - 65,000 Annually (Commensurate with experience) About Us CareAdvisors is a social care management organization dedicated to connecting individuals and families with the healthcare and social service benefits they need. We transform inefficient care coordination processes through innovative technology and community-based solutions, improving health outcomes for underserved populations. About the Role The Senior Clinical Social Care Specialist (CSCS) is an advanced clinical role responsible for managing high-acuity, medically complex, and multi-system cases across hospital, post-acute, community, and managed-care settings. This role requires Master’s-level preparation and deep experience coordinating care for members with significant medical, behavioral, and functional challenges. The CSCS functions as a clinical content expert, escalation point, and cross-disciplinary partner within Essence Community Care's clinical pathway. Core Responsibilities Advanced Clinical and Complex Case Management Manage a specialized caseload of high-acuity, clinically complex cases, including significant medical, behavioral health, functional, and SDoH needs. Conduct comprehensive clinical and psychosocial assessments to identify urgent and chronic barriers related to housing, food access, safety, behavioral health, caregiving support, income, and care continuity. Coordinate escalated care scenarios, including hospital discharges, SNF and SMRF placements, rehabilitation transitions, and complex benefit or eligibility challenges. Develop and implement individualized, clinically informed care plans aligned with multidisciplinary treatment goals and member needs. Serve as the primary point of escalation for complex appeals, denials, redeterminations, and multi-agency case involvement. Navigate Medicaid, SNAP, SSA, housing programs, and other benefit structures requiring detailed knowledge of rules, exceptions, and escalation pathways. Clinical Collaboration & Systems Navigation Partner with hospital discharge planners, MCO care managers, SNF administrators, behavioral health providers, and community stakeholders to support care continuity. Navigate Medicaid, SNAP, SSA, housing, and other benefit systems requiring advanced knowledge of rules, exceptions, and escalation pathways. Participate in multidisciplinary case reviews and lead discussions on complex cases. Subject-Matter Expertise & Mentorship (Non-Supervisory) Act as a clinical resource for A-CSCS and team staff on advanced casework, complex workflows, and benefit escalations. Provide input to leadership on process gaps, member risks, and quality‑improvement opportunities. Help reinforce clinical workflows, escalation pathways, and documentation standards across the team. Quality, Documentation & Compliance Meet or exceed expectations for accuracy, clinical detail, timeliness, and productivity. Maintain compliance with HIPAA, partner requirements, and internal guidelines. Demonstrate exceptional clinical judgment, professionalism, and accountability. Perform additional responsibilities aligned with organizational effectiveness and mission delivery. Minimum Qualifications (Required) Master’s degree required in Social Work, Counseling, Public Health, Psychology, Human Services, Healthcare Administration, or related field. 5+ years of experience in clinical social care coordination, complex case management, behavioral health, or managed‑care environments. Experience in hospital systems, FQHCs, behavioral health, post‑acute facilities, or MCO/health‑plan settings. Demonstrated expertise managing high‑acuity, multi‑system cases. Ability to coordinate across hospitals, SNFs/SMRFs, urgent care centers, MCOs, behavioral health providers, and community agencies. Advanced knowledge of Medicaid, SNAP, SSA disability, housing programs, and related benefits. Exceptional documentation, communication, and clinical‑reasoning skills. Proficiency with Microsoft Office, Google Workspace, and EHR/case management platforms. Reliable transportation, valid driver’s license, and insurance. Preferred Qualifications Clinical licensure (LSW, LCSW, LPC, LCPC). Bilingual capability. Experience with ACOs, MCOs, or value‑based care arrangements. Familiarity with Illinois/Wisconsin healthcare and social‑service systems. Experience with placements, appeals, denials, or complex benefits pathways. Equal Employment Opportunity Essence Community Care is committed to building a team that reflects the diversity of the communities we serve. Because the people we support are too often shaped by structural inequities, we believe representation, lived experience, and inclusive practice strengthen our mission. Essence Community Care is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, gender identity or expression, sexual orientation, age, marital status, pregnancy, disability, genetic information, military or veteran status, citizenship status, order of protection status, arrest record, or any other characteristic protected by federal, state, or local law, including the Illinois Human Rights Act. All qualified applicants are encouraged to apply. #J-18808-Ljbffr Essence Community Care