Degreed Social Worker - Health Plan

Degreed Social Worker-Health Plan
Job ID #1671908
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About this Role
Position is for a long term care case manager. LTC CM will be required to travel to nursing facilities to meet with members in person, and collaborate with nursing home staff. Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues. Field work in Central/West Chicago - ZIP codes 60644, 60624, 60651 or close by.
Job details
$30.02 / hour
Central/West Chicago, Illinois
Profession: Degreed Social Worker
Facility Type: ???
Specialty: Health Plan
Division: MedFi
Start Date: 11/25/2024
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Responsibilities
Determines medical necessity/ appropriateness Facilitates optimal outcomes
Identifies and follow through with continuous quality/ compliance opportunities .
May also include identification of aberrance's and initiation of corrective action
Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy
Optimize total costs Implementation and evaluation of policy based on usage and program directives
Required Qualifications
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health, human services, nursing
Minimum 2 years of relevant experience in case management and/or long term care facilities