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Senior Social Care Specialist

$58k - $62k

Essence Community Care

Role Role: Senior Social Care Specialist Type: Full-Time, Permanent Work Location: Hybrid Reports To : Sr Social Care Manager Salary: $58,000 - $62,000 About Us Essence Community Care is a Chicago‑based complex social care management organization dedicated to delivering high‑impact social care services in partnership with healthcare systems and local communities. We are building scalable, accountable infrastructure to serve vulnerable populations through evidence‑based outreach and coordinated complex case management. About the Role Essence Community Care is seeking an experienced Senior Social Care Specialist to manage a high‑acuity caseload of individuals with complex medical, behavioral health, and social needs. This advanced individual contributor role is responsible for high‑acuity case management, SNF/SMRF placement coordination, multi‑system navigation, benefits advocacy, and appeals resolution. The ideal candidate has experience within a large hospital system, a medium‑sized FQHC, or a managed care organization/health plan and is comfortable navigating discharge planning, utilization processes, and regulatory documentation standards. Core Responsibilities Complex Case Management and Customer Support Manage a dedicated caseload of high‑acuity members with complex medical, behavioral health, and social determinants of health needs. Coordinate escalated care scenarios, including hospital discharges, SNF and SMRF placements, rehabilitation transitions, and benefit‑related issues. Conduct comprehensive clinical and SDoH assessments to identify barriers related to housing, food access, safety, income support, and healthcare continuity. Develop individualized care plans in collaboration with clients, caregivers, providers, and community partners. Navigate Medicaid, SNAP, housing, disability supports, and other public benefit programs. Collaborate with hospitals, MCOs, FQHCs, behavioral health providers, and social service agencies to resolve barriers to care. Support members through appeals, denials, redeterminations, and complex eligibility issues. Maintain accurate, timely, and audit‑ready documentation in EHR and case management systems in accordance with internal policies and partner regulatory standards. Client Advocacy and Intensive Support Serve as an advocate for clients facing health, behavioral, or SDoH‑related challenges. Provide education and systems navigation support for clients, families, and caregivers. Coordinate closely with MCO case managers, hospital discharge teams, SNF administrators, and community partners to ensure continuity of care. Deliver culturally competent and trauma‑informed communication. Collaboration and Subject Matter Support (Non‑Supervisory) Act as a resource for staff regarding SNF/SMRF workflows, hospital discharge processes, benefit eligibility, and complex systems navigation. Participate in case reviews, quality meetings, and workflow discussions. Share insights on emerging trends and opportunities to improve workflows. Operational Excellence and Compliance Meet or exceed productivity, quality, and documentation expectations. Adhere to company policies, HIPAA requirements, Medicaid and MCO regulations, and partner compliance protocols. Demonstrate strong judgment, professionalism, and accountability in managing a high‑complexity caseload. Perform other duties as assigned that support organizational effectiveness and mission delivery. Qualifications Master's degree in Social Work, Counseling, Public Health, Healthcare Administration, Psychology, Human Services, or a related field; or commensurate experience. 4+ years in social care coordination, complex case management, or managed care environments. Experience working in large hospital systems, medium‑sized FQHCs, or MCOs/health plans. Expertise in managing complex, multi‑system cases and high‑acuity member needs. Strong knowledge of Medicaid, SNAP, housing, transportation benefits, and other essential services. Demonstrated expertise coordinating care across hospitals, SNFs, SMRFs, MCOs, and community‑based providers. Excellent written and verbal communication, documentation, and organizational skills. Ability to work independently, manage competing priorities, and adapt in a fast‑paced environment. Proficiency with Microsoft Office, Google Workspace, and EHR/case management platforms. Reliable transportation, a valid driver's license, and proof of insurance. Preferred Clinical licensure is a plus. Experience with Accountable Care Organizations (ACO), Managed Care Organizations (MCO), or other value‑based care environments. Familiarity with Illinois and/or Wisconsin healthcare and social service systems. Experience supporting clients through placements, appeals, or denials related to benefits. 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

Vacancy posted 12 hours ago
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