Social Worker Field Case Manager

We are seeking a compassionate and dedicated Social Worker Field Case Manager to join our dynamic healthcare case management team. In this role, you will work under a Certified Case Manager and alongside a Registered Nurse Telephonic Case Manager. Your day-to-day will be directly in the field, meeting our clients at medical appointments to advocate for their health needs, assessing patient needs, developing care plans, and coordinating resources to ensure optimal health and well-being. The ideal candidate will have strong social work skills, excellent communication abilities, and a deep commitment to advocating for the holistic care of patients in a community setting.

Key Responsibilities:

• Patient Assessment:
• Conduct comprehensive in-home or field-based assessments to evaluate patients’ social, emotional, and healthcare needs.
• Collaborate with patients, family members, and healthcare providers to develop and implement individualized care plans that address both healthcare and psychosocial needs.
• Care Coordination:
• Facilitate access to community resources, mental health services, social support, and necessary healthcare services for patients in the field.
• Stay informed of local community programs and services to ensure effective coordination of care and seamless access for patients.
• Patient Support and Education:
• Provide social work support, education, and emotional guidance to patients and their families during in-home visits.
• Empower patients to make informed decisions about their health, including providing resources on coping strategies and community support options.
• Monitoring and Evaluation:
• Regularly monitor patients’ progress in the field and adjust care plans as necessary to ensure optimal health outcomes.
• Maintain accurate and confidential documentation of patient interactions and case updates in compliance with organizational policies.
• Interdisciplinary Collaboration:
• Work closely with healthcare professionals, including physicians, nurses, and therapists, to provide comprehensive, patient-centered care.
• Actively participate in team meetings to discuss patient progress and ensure coordinated care efforts across disciplines.
• Advocacy and Education:
• Advocate for patients’ social and healthcare needs and assist in navigating community and healthcare resources.
• Educate patients and families on healthcare processes, rights, and available support services.

Advocate for resources and removal of barriers.

• Training and Development:
• Participate in ongoing professional development to stay current on the latest social work practices, case management strategies, and community resources.
• Share insights, best practices, and case studies with team members to improve the quality of care.
• Additional Responsibilities:
• Handle any situations that arise dealing with Adult Protective Services, Child Protective Services, and manage Legal Guardianship and Power of Attorney processes for clients.
• Manage residential placements for clients, including finding programs or housing such as low-income housing and adult foster care homes.
• Be knowledgeable in Medicaid Waiver Programs, VA Programs, and other relevant community support systems.
• Be familiar with food programs, addiction programs, mental health programs, pregnancy support programs, and other community-based resources.

Qualifications:

• Current Social Work licensure in the state of Michigan (LBSW, LMSW, or equivalent).
• Minimum 2 years of experience in social work or case management, preferably in a healthcare setting.
• Case Management Certification preferred, otherwise you must take CCM Exam within 2 years of working for the company.
• Knowledge of community resources, healthcare systems, and social work practice.
• Ability to work independently, manage time effectively, and adapt in a field-based role.
• Experience with Medicaid, Medicare, MiBridges, Food Stamps applications, Health Insurance Applications, SSI and SSDI applications, low-income housing applications, or any other resources are a plus.

Skills:

• Strong communication, interpersonal, and organizational skills.
• Proficient in using electronic health records (EHR) and case management software.
• Ability to assess and address both social and healthcare needs.
• Exceptional problem-solving skills and the ability to navigate complex social and healthcare systems.
• Ability to maintain confidentiality and handle sensitive patient information with professionalism.
• Exceptional time management skills, with the ability to manage a high volume of field-based visits.

Work Schedule:

• This position requires 5 days a week of in-office working with some time spent in the field as needed to meet client needs.
• You will assist field nurse case managers and telephonic nurse case managers with resources, barriers to care, and any applications for government resources.
• Hours: 8 AM - 5 PM.
• Travel is required 50% of working hours.
• Must be able to attend events, conferences, team meetings, and work events upon request.

Compensation:

• Competitive pay ranging from $28 to $32 per hour, based on experience and qualifications.

What We Offer:

• Comprehensive benefits package.
• Opportunities for professional development and continuing education.
• A supportive and collaborative work environment.
• The chance to make a meaningful impact in the lives of patients and their families.

Horizon Case Management is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Type: Full-time

Pay: $20 - $31.56 per hour

Expected hours: No less than 40 per week

Schedule:

• 8 hour shift

Work Location: In person

Job Types: Full-time, Part-time, Contract