Social Worker Field Care Coordinator - Miami/Dade area - Full-time / Part-time

The Social Worker Field Care Coordinator is responsible for facilitating, promoting and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients. Additionally, the care coordinator is responsible for assessing the availability of natural supports such as the enrollee's representative or family members to ensure the ongoing mental and physical health of those natural supports. The Care Coordinator collaborates with the Interdisciplinary Team to coordinate the delivery of comprehensive, efficient, cost effective patient care. The Care Coordinator works with program enrollees in the home and community setting, concentrating on providing holistic case management services to enrollees who need these. The Care Coordinator will be traveling into enrollees' homes, nursing facilities, and Adult Living Facilities (ALF) to conduct in-depth assessments and develop the plan of care. The Care Coordinator actively assists enrollees with care transitions in collaboration with the Interdisciplinary Team and the acute or skilled facility staff, and the enrollees and/or the enrollees' representatives. Care Coordinators act as liaison between the Health Plan, the Agency, enrollees, and their families. Care Coordinators follow established professional standards of care, Agency guidelines and policy and procedures.

***This position requires ACHA level II background checks (fingerprinting) by the state of FL for all clinicians that have face to face contact with members and will require renewal every five years.

Primary Responsibilities:

• Conducts initial and follow-up assessments within designated timeframes on enrollees identified as having complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial) 


• Assess the enrollees' current medical and social circumstances to identify any gaps or barriers that would impact compliance with the prescribed treatment plan 


• Acts as an advocate for patient care needs by identifying and communicating opportunities for care interventions, including identifying and addressing functional deficits and gaps in care 


• Develops a member specific Plan of Care that will be utilized to obtain authorizations for appropriate home and community based services 


• Develops and implements targeted strategies to improve health, functional or quality of life outcomes 


• Serves as a point of contact for coordination of all physical health, behavioral health and other home and community based services 


• Proactively educates enrollees about the program, including consumer direction of Home and Community Based Services 


• Coordinates with the Fiscal Employer Agent (FEA) for enrollees who opt for the consumer direction option, as needed 


• Monitors hospitalizations and institutional facility admissions and re-admissions to identify issues and implement strategies to improve outcomes


• Provides assistance in resolving concerns about service delivery or providers 


• Coordinates with enrollee's primary care provider, specialists and other providers and care programs to ensure comprehensive, holistic, person-centered approach to care 


• Routinely assesses and monitors enrollees' status, needs and progress; if progress is static or regressive, determine reason and proactively encourage appropriate adjustments to the plan of care, providers and/or services to promote better outcomes 


• Reports quantifiable impact, quality of care and/or quality of life improvements as measured against the care coordination goals 


• Establishes and maintains professional working relations with community resources and care providers 


• Collaborates with peers on enrollees' admissions, transitioning and/or discharge planning Refers service requests that do not meet approval criteria to Manager, Director, or RN for further review and determination 


• Performs other social services-related case management duties as needed
  

Required Qualifications:

• Master's Degree in Social Work, Sociology, Psychology, Gerontology or a related social services field 


• 3+ years of behavioral health experience and/or work in a healthcare environment 


• Proficient computer skills including the ability to type and talk at the same time and toggle between multiple screens 


• Bilingual skills (Fluency in Spanish/English) 


• Ability/willingness to travel daily within the service delivery area (Miami/Dade)

Additional Preferred Assets:

• Active and unrestricted behavioral health license in the state of FL (i.e. LCSW, LMFT, LPC, LMSW) is highly desired 


• Long term care experience 


• Case management/care coordination experience in a clinical setting (hospital, long term care) or managed care 


• Experience providing care coordination to persons receiving long-term care and/or home and community based services 


• Experience with medical social work
  

UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.

We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.

This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: social worker, case manager, care coordination, medical social work, psychology, Medicaid, Medicare, LCSW, Miami, Dade, FL