Clinical Support, Licensed Social Worker

Overview:

The Clinical Support Licensed Social Worker provides clinical expertise and behavioral health support to Care Management operations, helping to ensure integrated, member-centered care across the physical and behavioral health continuum. This role supports high-risk members, collaborates with interdisciplinary teams, and helps operationalize quality, compliance, and regulatory initiatives, including corrective action plan (CAP) requirements. The Clinical Support Licensed Social Worker serves as a key resource for behavioral health consultation, care coordination, and program development to improve member outcomes and strengthen care delivery.

This position is in the office 3 days/week.

What We Provide:

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs 
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care  
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement 
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities.

What You Will Do:

• Participate in interdisciplinary rounds, case conferences, and care coordination meetings.
• Manage a Behavioral Health Care Management (BH CM) caseload for members with complex behavioral health and psychosocial needs.
• Serve as a Health Home and HARP liaison to support coordination, communication, and program integration.
• Provide clinical consultation and guidance to Care Management staff regarding behavioral health conditions, social determinants of health (SDoH), and member engagement strategies.
• Conduct outreach and follow-up activities related to quality initiatives, including depression screening follow-up, substance use disorder engagement, and other behavioral health interventions.
• Support care transitions and engagement of high-risk members across care settings.
• Collaborate with Utilization Management, Care Management, Quality, and Compliance teams to develop and enhance clinical workflows and operational processes.
• Assist in implementing and monitoring corrective action plans (CAPs), Medicaid Managed Care readiness activities, and other regulatory requirements.
• Support chart audit activities, including audit tool development, revision, execution, and monitoring.
• Identify barriers to care and connect members with appropriate behavioral health, community, and social service resources.
• Maintain timely, accurate, and compliant documentation in accordance with organizational and regulatory standards.
• Contribute to the development of programs and initiatives that improve behavioral health integration and continuity of care.

Licenses and Certifications:
Current license to practice as a Licensed Social Worker in New York State Required.