Coordinator, Social Work Denver Health Medical Plan ( Must Live In Colorado )

We are recruiting for a motivated Coordinator Social Work - Denver Health Medical Plan (

• Must Live In Colorado
• ) to join our team!

We are here for lifes journey.

Where is your life journey taking you

Being the heartbeat of Denver means our heart reflects something bigger than ourselves something that connects us all :

Humanity in action Triumph in hardship Transformation in health.

Department

Managed Care Administration

Remote Opportunity For Colorado Residents Only.

Job Summary

Under general supervision the Health Plan Social Work Care Coordinator (SWCC) is responsible for facilitating and coordinating the care delivered to an assigned group of members using multidisciplinary and member / family collaboration to ensure quality and cost effective outcomes are delivered within appropriate care coordination parameters. Coordination involves assessment of care needs planning support and evaluation of member care and related outcomes. Activities to be performed are screening and assessment of medical behavioral health and social determinants needs and gaps in care collaboration with the Member to develop a care plan with SMART goals scheduled outreach to support member in achieving their goals and supporting the Members self-efficacy to navigate systems. SWCC communicates closely with the Members care team inclusive of : the Member designated health representatives primary care provider behavioral health providers and other care coordinators involved with the Members care. Encounters occur face to face telephonically and electronically with members in clinic and in other community-based settings.

Position is an active contributor in the development of systems (e.g. work flows clinical pathways assessments) to improve the care of assigned member populations. Helps ensure compliance with state federal and third party payor requirements.

Essential Functions :

Systematically collects focused data relating health needs and concerns of member group or population.

Establishes and maintains member-centered relationships.

Analyzes assessment data to determine opportunities for health promotion health maintenance or health related problem needs and statements.

Identifies and executes evidence-based interventions to support the Member in achieving their health goals.

Identifies and works towards expected outcomes in a plan of care individualized for a specific member group or population.

In collaboration with the Member develops a care plan that identifies strategies and alternatives to attain expected outcomes. Utilizes competent evidence based telephone encounters and electronic communications according to regulatory requirements and standards as well organizational policies and procedures.

Conducts systematic evaluation of outcomes of care coordination in relation to structures and processes prescribed by plan.

Documents in readable understandable language according to professional regulatory and agency standards.

Documents and disseminates results of care to member caregivers and others involved in the care or situation as appropriate in accordance with contractual requirements state and federal laws regulatory requirements and Denver Health policy.

(25%)

Coordinates the delivery of care within the clinic setting throughout the organization and across health care settings.

Provides relevant information across the care system within Denver Health and with other healthcare systems and payers when member care is transferred between and among different specialties and / or within one or more organizations.

Provides information to the health care team including the member family and caregiver regarding available resources and benefits for health care services that ensures member choice and safe timely transition.

Serves as point of contact within and among healthcare services and organizations.

Coordinates community resources.

Assures designation of primary responsibility among team members for each aspect of care plan avoiding duplication and fragmentation.

Facilitates continuity of care using the multidisciplinary collaboration and coordination of all appropriate healthcare services and community resources across the care continuum.

Orients member / caregiver to health care delivery system services access and resources. 25%)

Identifies barriers to goals and strategies to address.

Provides personalized education for optimal wellness.

Encourages preventative care such as immunizations and cancer screening.

Promotes appropriate utilization of resources.

Assists and educates caregiver when member is unable to participate.

Incorporates therapeutic communication health literacy cultural and linguistic needs and preference into education and goals.

Supports members and caregivers in developing skills for self-efficacy to promote maintain or restore health such as healthy lifestyle tips risk-reducing behaviors age and developmental needs daily living activities and preventative care. (25%)

Responsible for a defined caseload of Members enrolled in the DHMP Medicaid Choice who are identified as having a medium or low risk acuity level using data from a variety of sources including the Member their caregivers providers administrative claims data pharmacy data and other inputs.

Obtains Member consent to participate in the program as well as to share clinical information with the Members care team.

Works collaboratively with the Member to set SMART (specific measurable attainable realistic and time-limited) goals and to graduate the Member to lower-intensity care programs and self-care within reasonable timeframes.

Works under the supervision and advice of the Supervisor who can provide insight into medical conditions treatments medications and answer medically-related questions as needed.

(25%)

Education :

Work Experience :

Licenses :

Knowledge Skills and Abilities :

Shift

Days (United States of America)

Work Type

Regular

Salary

$61200.00 - $94800.00 / yr

Benefits

Outstanding benefits including up to 27 paid days off per year immediate retirement plan employer contribution up to 9.5% and generous medical plans

Free RTD EcoPass (public transportation)

On-site employee fitness center and wellness classes

Childcare discount programs & exclusive perks on large brands travel and more

Tuition reimbursement & assistance

Education & development opportunities including career pathways and coaching

Professional clinical advancement program & shared governance

Public Service Loan Forgiveness (PSLF) eligible employer free student loan coaching and assistance navigating the PSLF program

National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

Respect

Belonging

Accountability

Transparency

All job applicants for safety-sensitive positions must pass a pre-employment drug test once a conditional offer of employment has been made.

Denver Health is an integrated high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center a 555-bed acute care medical center Denvers 911 emergency medical response system 10 family health centers 19 school-based health centers Rocky Mountain Poison & Drug Safety a Public Health Institute an HMO and The Denver Health Foundation.

As Colorados primary and essential safety-net institution Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community focusing on hiring and purchasing locally as applicable serving as a pillar for community needs and caring for more than 185000 individuals and 67000 children a year.

Located near downtown Denver Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas talents and contributions reflective of the needs of our community.

Applicants will be considered until the position is filled.

Required Experience :

IC

Key Skills

EMR Systems,Motivational Interviewing,Hospital Experience,Acute Care,Communication skills,Bereavement Counseling,Hospice Care,Case Management,Computer Literacy,Home Care,Medicare,Social Work

Employment Type : Full-Time

Experience : years

Vacancy : 1

Monthly Salary Salary : 61200 - 94800