Clinical Support, Licensed Social Worker

Overview:

The Clinical Support Licensed Social Worker provides clinical expertise and behavioral health support to Care Management operations, helping to ensure integrated, member-centered care across the physical and behavioral health continuum. This role supports high-risk members, collaborates with interdisciplinary teams, and helps operationalize quality, compliance, and regulatory initiatives, including corrective action plan (CAP) requirements. The Clinical Support Licensed Social Worker serves as a key resource for behavioral health consultation, care coordination, and program development to improve member outcomes and strengthen care delivery. 

This position is in the office (4 days/week)

• Referral bonus opportunities     
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays   
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability    
• Employer-matched retirement saving funds   
• Personal and financial wellness programs    
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care     
• Generous tuition reimbursement for qualifying degrees   
• Opportunities for professional growth and career advancement    
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities.

• Participate in interdisciplinary rounds, case conferences, and care coordination meetings.
• Manage a Behavioral Health Care Management (BH CM) caseload for members with complex behavioral health and psychosocial needs.
• Serve as a Health Home and HARP liaison to support coordination, communication, and program integration.
• Provide clinical consultation and guidance to Care Management staff regarding behavioral health conditions, social determinants of health (SDoH), and member engagement strategies.
• Conduct outreach and follow-up activities related to quality initiatives, including depression screening follow-up, substance use disorder engagement, and other behavioral health interventions.
• Support care transitions and engagement of high-risk members across care settings.
• Collaborate with Utilization Management, Care Management, Quality, and Compliance teams to develop and enhance clinical workflows and operational processes.
• Assist in implementing and monitoring corrective action plans (CAPs), Medicaid Managed Care readiness activities, and other regulatory requirements.
• Support chart audit activities, including audit tool development, revision, execution, and monitoring.
• Identify barriers to care and connect members with appropriate behavioral health, community, and social service resources.
• Maintain timely, accurate, and compliant documentation in accordance with organizational and regulatory standards.
• Contribute to the development of programs and initiatives that improve behavioral health integration and continuity of care.

Licenses and Certifications:
Current license to practice as a Licensed Social Worker in New York State Required.

Education:
Master's Degree in Social Work Required.

Work Experience:
Minimum of three years Social Work experience in a managed care, home care or community based health care organization required. Experience in geriatric care preferred. Demonstrated clinical competence in social work required. Ability to multi task in a fast paced setting, listen attentively, evaluate calls, and use judgment in a time sensitive environment required. Effective oral/written communication, analytical and interpersonal skills required. Knowledge of Medicaid and/or commercial regulations preferred. Proficiency in MS Word, Excel, and data systems required. Bilingual skills may be required, as determined by operational needs.