KECH Inc. · 2 days ago
Remote Disease Condition Manager, Social Worker (SW)
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Business DevelopmentConsulting
Comp. & BenefitsNo H1BSecurity Clearance Required
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Responsibilities
Assess beneficiaries to identify medical, physical, and psychosocial needs to support the beneficiary’s overall goals of care.
Collaborate with the clinical to contribute to the whole-person plan of care by incorporating behavioral and psychosocial assessment findings utilizing evidence-based guidelines, clinical reasoning and clinical practice guidelines.
Provide education and coaching support specific to the beneficiary’s behavioral and psychosocial needs to prevent to support management of their chronic condition.
Manage activities necessary to ensure appropriate utilization and access to medical and behavioral resources, while maintaining optimal standards of care.
Review, identify and assist with identification and facilitation of resources related to health disparities identified through SDOH assessment.
Participates in the development of measurable outcomes, ensures measure are in place to monitor the impact of programs and services on the health status of beneficiaries being managed.
Assesses high risk factors, acuity and need for other TRICARE services and resources.
Facilitate transfer of beneficiary between the different regions and within the regions by collaborating with the military liaison to support the transition with minimal disruption.
Adhere to URAC standards, TRICARE policy, contractual requirements, and nationally recognized practice standards.
Regular and reliable attendance. Must be flexible to work an 8-hour shift between 9 AM ET and 12 AM ET Monday through Friday, and available for occasional OT.
Qualification
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Required
Current, unrestricted SW licensure to independently work within scope of practice within state of residence (BSW)
Two (2) or more years of experience in case management, care coordination or discharge planning in an acute, ambulatory or specialty disease management program settings in a healthcare system or managed care organization (MCO)
Proficiency in medical data entry, written skills and Microsoft Office
Exceptional oral communication skills, strong organizational skills and easily adapts to change
Candidates must pass an extensive background check and credit check to begin work
Candidates must be eligible to obtain a government security clearance and cannot be delinquent on any Federal debt
Preferred
Care or Disease Management experience with a managed care organization (MCO)
Master’s degree in Social Work MSW; LCSW, LMSW
Knowledge of government healthcare programs, TRICARE, and Medicare/Medicaid
Benefits
VACATION: 80 hours
HOLIDAYS: 6 + 1 floating holiday: New Year's Day, Memorial Day, Independence Day, Labor Day, Veterans' Day, Thanksgiving Day, and Christmas Day.
Full medical, dental, vision, and life benefits available.
EAP program
401k with matching
Dental insurance
Employee assistance program
Health insurance
Life insurance
Paid time off
Vision insurance