Clinical Programs Social Worker Call Center - BSW - Remote

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

The WellMed Quality Clinical Programs team supports WellMed Medical Management by by delivering patient-centered, clinically collaborative telephonic outreach to help people live healthier lives. Our team focuses on the design, execution, and delivery of telephonic and digital engagement strategies designed to close STARs measure gaps for routine screenings and getting needed care. Our interdisciplinary service delivery team is comprised of Registered Nurses, Licensed Vocational Nurses, and Social Workers.

The Social Worker will report into the Manager of Clinical Programs. The Social Worker will perform telephonic, patient-centered outreach focused on addressing Social Determinants of Health (SDoH) and act as a liaison to assist in coordinating resources to the care and health of members. The primary scope is to provide assistance to patients/members and their families as requested with SDOH, personal, ethical, and environmental difficulties to enhance quality of life. The Clinical Programs Social Worker acts as an advocate for members and their families, linking them to community resources and financial assistance programs for continued growth toward a maximum level of independence.

The Social Worker will be required to meet or exceed established productivity and quality metrics and work a flexible schedule to support the hours of operation of the business (Mon-Fri 8am-6pm Central and Saturday 8am-5:30pm Central)

If you are licensed in Texas and/or Florida, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Conduct telephonic outreach that meet/exceed quality metrics and meet or exceed production targets established for these outreaches
• Meet and/or exceed department standards for member outreach turnaround times
• Perform comprehensive assessments and document findings in a concise and comprehensive manner that is compliant with department documentation requirements
• Provide members/patients with internal and external resources and support to improve Social Determinants of Health, non-medical needs and quality measures. (Pharmacy assistance programs, meals on wheels, LIS)
• Coordinates outpatient needs related to community resources, financial assistance programs, and long-term activity of daily living needs outside the benefit criteria of the medical insurance coverage
• Collaborates with market Social Workers, members, PCP's and specialists as needed and provides related feedback on planned interventions and outcomes of plan of care
• Identifies and assists patients/members with SDOH, high-risk diagnoses and/or multiple co-morbidities who will benefit from social care coordination, contracts, providers, and facilities
• Along with the care team, reviews the need for, and assists with obtaining DME, home health and other resources necessary for the patient. Provides patients/members with education about community resources and options and advocates on behalf of the patient
• Takes ownership of the total work process and provides constructive information to minimize problems and increase internal and external customer satisfaction
• Assist with provider outreach for notification of gaps in care and requesting medical records
• Assists in the growth and development of self and associates by sharing special knowledge with others
• Performs all other related duties as assigned
• Position is telecommuter, work from home

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Bachelors in Social Work (BSW) from an accredited program
• Active, unrestricted Licensed Social Worker (LBSW) in the state of Texas or Florida
• 2+ years of experience actively working as a social worker
• 2+ years clinical background with broad range of experience in health care delivery setting (hospital, clinic, physician's office, community work)
• 2+ years of experience in patient or member facing roles
• Experience with Social Determinates of Health (SDoH) and addressing associated barriers
• Proficient in PC software computer skills such as Microsoft Word, Excel, Power Point, Outlook
• Proven excellent written and verbal communication and relationship building skills
• Proven ability to effectively and efficiently transition to multiple assignments
• Proven ability to manage multiple complex, concurrent projects
• Proven independent problem identification/resolution and decision-making skills
• Proven ability to work independently as well as a member of a team

Preferred Qualifications:

• Graduate of an accredited Master's degree Social Work Program
• Active/unrestricted licensed Masters in Social Work (LMSW) in TX and/or FL
• Experience working with geriatric patient populations.
• Call Center experience
• Knowledge of STARs and HEDIS measures, managed care, medical terminology, referral process
• Bilingual with preference given to Spanish and Vietnamese
• Proven ability to work effectively in a fast paced call center environment

Physical & Mental Requirements:

• Ability to push or pull heavy objects using up to FORMTEXT FFFFFFFF00000000140006005400650078007400340036000000000000000000000000000000000000000000000000000000 pounds of force
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to properly drive and operate a company vehicle

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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