Service Coordinator Advanced Social Worker-TYLER TX AREA

We are searching for a Service Coordinator Advanced Social Worker for Northeast (Tyler) for The Health Plan-- someone who works well in a fast-paced setting. In this position, you will function as a member of the interdisciplinary healthcare team in the provision of Level I (and higher) patient care with the underlying objectives of enhancing the quality of clinical and financial outcomes and patient satisfaction while managing the plan of care. Within the purview of financial management, this role pro-actively communicates with members of the healthcare team to ensure appropriate medical necessity for patients in beds and communicates with Payers and patient/family/healthcare team regarding payer information as necessary.

Think you’ve got what it takes?

Responsibilities
•    Completes a comprehensive problem identification analysis of Level I (and higher) patients to identify opportunities for intervention that are appropriate and realistic for the patient/family’s psycho-social, cultural, spiritual, and physical plan of care
•    Performs initial assessments and follow-up assessments as well as contact calls within the time period specified as a result of acuity assessment or within two weeks upon Member/family/provider request
•    Plans and executes interdisciplinary and patient/family conferences as necessary to formulate and communicate the plan of care
•    Initiates and implements plan modifications during the episode of hospitalization and for post-acute care through monitoring and re-evaluation to accommodate changes in treatment or progress
•    Serves as a liaison between members of the interdisciplinary care team, community providers, payer sources, and patient/family to ensure safe and effective plans and smooth transitions between internal and external levels of care
•    Assures timely performance of utilization management processes to maintain compliance with Federal, State, and Managed Care contract regulations
•    Maintains current education and training to adeptly identify the Member's physical, behavioral, functional, and psychosocial needs

As part of our commitment to maintaining a safe and healthy workplace, all successful candidates will be required to undergo respiratory fit testing in compliance with occupational health and safety standards

Requirements
•    Master’s degree in social work required
•    LMSW or LCSW from the Texas Board of Social Work Examiners required
•    Driver’s license from any state required
•    Current automobile insurance required
•    C-ASWCM from the National Association of Social Workers preferred
•    CCM from Adult and Pediatric Integrated Case Management preferred
•    3 years’ experience in pediatrics particularly with patients with disabilities aged 0-20 preferred
•    Knowledge of Microsoft Word, Excel and Outlook preferred

•    MCO experience is a plus

Candidate must reside in TYLER TX or close proximity to TYLER TX. 

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