Field Social Worker Clinician Case Manager

About the Job This position will be responsible for the Annual and periodically required Comprehensive Clinical Assessment as cited in section C.3.27.2 of the Department of Health Care Finance awarded contract. The Field Case Manager Social Work Clinician will be responsible for the District of Columbia Region and will travel up to 85 % of the time to serve MedStar Family Choice District of Columbia enrollees. The Field Case Manager SW Clinician serves as the central point of contact for MedStar Family Choice D.C. case management and conducts the activities and functions required for this role. Responsibilities include referral of enrollees to other MedStar Family Choice programs such as Maternal Health, Behavioral Health, Food Insecurity relief, and Non‑Medical Transportation, as well as reporting on enrollees requiring assistance with Medicare and/or Medicaid beneficiary support, nursing home placement, crime victim vocational rehabilitation, and other third‑party coverage, including local, state and federal programs. Primary Duties and Responsibilities Integrates physical, behavioral and social environmental factors into a single person‑centered, seamless system of care. Promotes a person‑centered approach to service and care planning that honors each member’s priorities, goals, needs and preferences. Encourages enrollee engagement in the person‑centered service planning process and the use of planning teams with expertise in community integration and behavioral health. Leverages providers, community partners and local community resources to ensure comprehensive, coordinated and culturally appropriate care. Provides service and support to maintain members in the least restrictive and most appropriate setting possible. Leverages evidence‑based practice guidelines, clinical pathways, technology solutions and clinical decision support tools. Provides case management for a designated member population, including support for self‑direction, nursing home transition, transition of care and Utilization Management activities; completes field‑based member assessments and identifies activities and interventions based on member needs. Oversees daily, weekly and monthly functions of the Field Case Manager SW, coordinating member assessments and establishing priorities; performs clinical analysis, documentation and follow‑up for member clinical reviews and similar duties. Prepares and provides reports to manager(s) on work in progress and addresses backlogs for resolution. Informs members about annual required assessments, in‑person centered service planning processes, service alternatives and delivery options (e.g., opportunities for self‑direction, rights, including MedStar Family Choice D.C. Fair Hearing rights, risks and responsibilities); assists with fair hearing requests as needed. Collects necessary information, including member preferences, strengths, and goals, to inform development of person‑centered needs plans and reevaluation of level of care annually or more frequently. Assists members with person‑centered care plans and activities needed to maintain MedStar Family Choice D.C. eligibility. Explores coverage of services through other sources such as Medicare, private insurance and community resources. Actively coordinates with other individuals and entities in members’ care delivery for physical, behavioral and support service needs. Ensures MedStar Family Choice DC policies, procedures, training, quality oversight and monitoring for staff and contracted field case managers, maintaining consistency in the execution and delivery of our MFC Model of Care. Minimal Qualifications Education Bachelor’s degree in Nursing, Social Work or a related clinical field required Master’s degree in Social Work required Experience 1‑2 years of experience, including at least one year in a social service or health care related setting 1‑2 years of experience working with people with developmental disabilities, HIV, behavioral health and/or other related vulnerable populations Licenses and Certifications LCSW – Clinical Social Work License upon hire required Knowledge, Skills and Abilities Knowledge of the home and community‑based service system and how to access and arrange for services Ability to conduct field‑based member assessments up to 85 % of the time Experience conducting Department of Health Care Finance needs assessments Cultural competency and ability to provide informed advocacy Ability to interact with physicians and other health care professionals in a professional manner Experience with section C.3.27.2 of the Department of Health Care Finance awarded contract This position has a hiring range of USD $74,214.00 – USD $134,596.00 per year. #J-18808-Ljbffr MedStar Health