Medical Social Worker

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

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Full-time

Competitive Total Compensation Package

Overview: <strong>Support the overall improvement of member&rsquo;s health status in collaboration with the case managers and physicians by identifying and referring member&rsquo;s to community resources, counseling and/or support services. Educate patients about entitlement programs, legal issues or other services relevant to social work practice skills and knowledge.</strong>
Responsibilities: <ul> <li>Develop, coordinate and evaluate a social worker assessment for identified members.</li> <li>Consult and coordinate with the case manager and physician to identify member issues and develop a plan to resolve the issues.</li> <li>Assess the member&rsquo;s progress to social work intervention and community services provided through on site visits and POD review sessions upon invitation.</li> <li>Assist the Case Manager with psychosocial needs assessment and identification of appropriate resources.</li> <li>Identify and refer members to community resources, counseling, and/or support for the member and/or authorized representative, as needed.</li> <li>Document all activities as appropriate, including but not limited to member assessment, communication with case managers, PCP or issues related to guardianship, abuse/neglect.</li> <li>Educate the member and/or authorized representative about entitlement programs (i.e., Medicaid, Social Security), legal issues (i.e. guardianship, advanced directives) and assisting in the application process as needed.</li> <li>Assist the member and/or authorized representative with long-term care planning and of end of life decisions and options as needed.</li> <li>Provide member support as needed throughout hospice period.</li> <li>Provide member receiving hospice services with information regarding appropriate community resources.</li> <li>Travel may be required.</li> </ul>
Requirements: <ul> <li>Master&rsquo;s Degree in Social Work required.</li> <li>Minimum of five (5) years of board medical social work experience required.</li> <li>Minimum of two (2) year to be in home health care and/or medical case management preferred.</li> <li>Current unrestricted Licensed Master&rsquo;s Social Worker or Limited License in Psychology in the State of Michigan is required.</li> <li>Knowledge of clinical programs and P&amp;P, HIPAA regulations and guidelines, American Disability Act, URAC standards (CM SW only) and clinical ethics.</li> <li>Motivational interviewing skills as well as experience in performing assessments and interventions.</li> <li>Knowledge of Medical Policy, CM and DM principles and alternate levels of care.</li> <li>Knowledge of BCBSM/BCN benefits.</li> <li>Basic computer applications/Microsoft word/typing required.</li> <li>CM, CCM Admin Modules and Care Advance systems.</li> <li>VDA, Virtual Desk Top (work from home).</li> <li>Ability to engage and motivate the member or member representative, mentor and train.</li> <li>Identify existing and or potential psychosocial and quality of care issues.</li> <li>Interact and collaborate with multidisciplinary team while advocating on member&rsquo;s behalf.</li> <li>Providing effective written and verbal communication/feedback.</li> <li>Organizational skills and ability to prioritize and have a flexible work schedule.</li> </ul>