About this role
We’re looking for a Social Worker, someone who’s ready to grow with our company. In this position, you’ll assess, plan, implement, monitor and evaluate the options and services required to meet an individual’s health needs. You'll provide comprehensive ongoing case management services to Health Plan members by coordinating and managing care of high risk members to meet multiple service needs across the continuum of care, ensure optimal member outcomes that address quality, service, customer satisfaction and cost effectiveness. You'll also assists the member/member's family in coping with illness by optimizing the member's/family's self-care abilities and support their consumer rights.
Think you’ve got what it takes?
Job Duties & Responsibilities
Assesses, develops, implements and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the member/family in internal and external settings 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, staff, home care staff, and other internal areas Comprehensively assesses member’s biophysical, psychosocial, environmental, discharge planning needs and financial status Participates in planning and coordinating services across the continuum of care and documents this plan in designated system Ensures provision of continuity of care needs as required and serves as advocate on behalf of members and families on an ongoing basis across the continuum of care Identifies problems/barriers/opportunities for intervention and provides resolution and revision of plans on an ongoing basis Routinely assesses member’s status and progress; if progress is static or regressive, determines the reason and proactively encourages appropriate adjustments in the care plan, providers and/or services to promote better outcomes Performs all necessary communication and documentation functions Communicates continually with members/families, medical staff, caregivers, and primary HMO staff to facilitate appropriate, timely, and cost effective care Collaborates with community health education/outreach organizations and providers to support overall health promotion of members Completes home visits and clinic or hospital visits with members as indicated Conducts provider and member education activities Educates providers on network compliance and policies and procedures, managed care and Medicaid Accurately assesses own learning needs and develops strategies to meet them and is motivated to utilize computer-based distance learning Stays informed of current healthcare developments to provide safe, quality social work Prepares and monitors outcome data to assist in identification of improvement opportunities Arranges and monitors appropriate care and services for members
Skills & Requirements
Master's Degree Social Work required LMSW - Licensed Master Social Worker by the Texas Behavioral Health Executive Council (TBHEC) or LCSW - Licensed Clinical Social Worker by the Texas Behavioral Health Executive Council (TBHEC) or LMSW-AP - Licensed Master Social Worker - Advanced Practice by the Texas Behavioral Health Executive Council (TBHEC) required 2 years clinical experience required Authorization to Release Personal Information must be signed prior to beginning work in this role. As a remote worker/road warrior, this consent allows us to disclose an employee’s home address for the purposes of geo-mapping.
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 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.