Social Worker-Utilization Management

Position: Social Worker-Utilization Management

Job ID: 150591

Location: US-TX-Bellaire

Department: Utilization Management

Talent Area: Social Worker

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit for career opportunities. You can also learn more about our amazing culture at


We are searching for a Social Worker—someone to provide comprehensive ongoing case management services to Texas Children’s Health Plan members by coordinating and managing care of high risk members in order to meet customer satisfaction and cost effectiveness.  This applicant will utilize a collaborative approach to assess, plan, implement, monitor and evaluate the options and services required to meet an individual’s health needs. The social worker will work with members with complex and behavioral health needs.


Do you think you’re the right person for the job?


Responsibilities :


• Participates in planning and coordinating services across the continuum of care and documents this plan in designated


• Communicates continually with members/families, medical staff, caregivers, and primary HMO staff to facilitate

appropriate, timely, and cost effective care

• Proactively identifies members in need of case management through clinical rounds, medical management

staff referrals, consultation with primary HMO staff, medical director and PCP, parents, TCH staff, home care staff, and

other internal TCHP areas

• Provides community education/outreach for TCHP members when needed for Health promotion for chronic disease

management and health and wellness information      

• Communicates the utilization assessments needed to provide for appropriate levels of care during stays of illness and for

continuity of care needs.

• Must have excellent verbal and written skills as well as be able to operate a personal computer, word processing programs,

fax machine, photocopier and multi-line telephone.                   


• Master’s degree in Social Work from an accredited School of Social Work

• Licensure as Social Worker in the State of Texas Can create a thorough psychosocial assessment and develop, implement and evaluate a plan of care  (LMSW or LCSW)

• Ability to demonstrate excellent professional listening and communication skills Preferred: Previous employment in health care, a health care specialization in schooling or a field work practicum in health care.

• 2yrs of clinical experience (preferable a background in behavioral health

Apply Now
Current Texas Children’s employees – Please click here to login.
Create Profile or Log In Search Careers