Social Worker-Care Management

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="" 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="" 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="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: legal,performance,analysis,support,security,document,travel,knowledge,experience,license,skills,degree


Competitive Total Compensation Package

Overview: 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.
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’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’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’s Social Worker or Limited License in Psychology in the State of Michigan is required. </li><li>Knowledge of clinical programs and P&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’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>