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We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.
The Social Complex Manager (SCM), LCSW is a Licensed Clinical Social Worker (LCSW) that works closely with the PCP, Medical Specialists and other members of the Complex Care team such as Post Hospital Care Coordinators, Post Hospital Care Manager, Hospital Care Managers, and Intensive Community Case Managers. The incumbent in this role provides direct assessment, diagnosis formulation, treatment planning and intervention to patients who have chronic, life threatening or altering diseases and disorders, and education to patients and/or families. He/She advocates for services and resources for the underprivileged and victims of abuse, neglect or other difficult personal situations. The Social Complex Manager (SCM) adheres to strict departmental goals/objectives, standards of performance, quality patient care compliance, and policies and procedures as defined by industry standards and the enterprise. The success of this role is determined by the impact proper behavioral care management has on patients with complex behavioral needs on preventing unnecessary hospital arrivals.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Assessment and Diagnosis
Conducts timely and appropriate assessment, prioritizing patients on the Intensive Complex Care (ICC) caseload, PCP’s High Priority Patients (HPP) and Top 40 patient list. Assesses patients for behavioral, psychosocial, financial, family issues, palliative care/end of life issues, home safety, etc. that contribute to hospitalization with a primary focus on behavioral needs support.
Dialogues with PCPs in order to support and advise concerning behavioral health (BH) disorders.
Treatment
Identifies, manages and coordinates appropriate BH treatment planning and interventions, prioritizing patients on the on the Intensive Complex Care (ICC) caseload, PCP’s HPP and Top 40 patient lists.
Serves as a linkage between PCPs, outside BH providers, and patients to improve coordination of services and information flow.
Can assist with obtaining community resources or refer to in house Community Social Worker when available and appropriate.
Provides self-management support and ongoing phone contact with patients.
Inpatient Psych Care Coordination
Coordinates and manages the needs of behavioral health patients who are hospitalized through the internal EMR (“HITS”) High Priority Patient (HPP) registry.
Communication
Maintains communication with other healthcare team members by attending appropriate meetings (i.e. weekly Super Huddles and Transitional Care Team meeting.).
Provides clinical consultation in an integrated health care environment regarding behavioral health diagnosis and needs, family interactions, social determinants of health, and BH community resources.
Documentation
Maintains timely, accurate, thorough and appropriate documentation/reports per company policies and procedures. Initial biopsychosocial assessments will be completed within 48 hours. All follow up visits phone calls and collaborative contacts will be documented within 24 hours. LCSW/BHS will assure documentation meets billing guidelines.
Licensure
Maintains LCSW state licensure by meeting yearly requirements. Attend behavioral health training seminars/continuing education to maintain current state LCSW License. ChenMed/JenCare/Dedicated provides 5 CEU days for this purpose to LCSW/BHS.
Clinical Supervision
Provides clinical supervision for market Social Worker as requested.
Additional duties and responsibilities may include:
Connecting patients with mental health and/or community resources in order to help them maintain an optimum level of health.
Performs other duties as assigned and modified at manager’s discretion.
Highly-developed business acuity and acumen
Full knowledge, understanding and comprehension of general Clinical Social Worker functions, practices, processes, procedures and techniques
Expertise in a variety of evidence-based behavioral health modalities needed for clinical diagnosis and treatment
Knowledge of counseling techniques used in individual, family and group treatment, as well as principles of social welfare
Knowledge of evidence-based behavioral health methods and techniques used in individual, family and group therapy as related to mental health and/or substance abuse issues in a primary care setting.
Knowledge of normative changes (e.g., sensory, cognitive, psychosocial) associated with aging for high-risk patients
Knowledge of advance care planning and palliative care, and related skill in addressing advance care planning with patients and/or their family systems
Ethical practice behavior consistent with ChenMed/JenCare/Dedicated policies and professional standards
Skill in psychosocial interventions with caregivers/family systems of high-risk patients
Teamwork skills in care coordination with patients, family systems, internal staff, and external providers
Appropriate utilization of community-based resources
Ability to work autonomously is required
Ability to monitor, assess and record patients’ progress and adjust accordingly
Ability to communicate technical information to non-technical personnel, and with patients and/or their family systems
Strong interpersonal, communication and critical thinking skills and the ability to work effectively with a wide range of constituencies in a diverse community
Demonstrated ability to provide care effectively and sensitively to people from different cultural groups
Ability to create a collaborative relationship to maximize the patient’s/family’s ability to make informed decisions.
Proficiency in written communication: documentation is clear, concise, and accurate, provides meaningful communication and is consistent with policy and regulatory requirements.
Proficiency in technology, including the utilization of Electronic Medical Record platforms for care coordination.
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
Ability and willingness to travel locally, regionally and nationwide up to 50% of the time
Spoken and written fluency in English
This job requires use and exercise of independent judgment
Master’s degree of Social Work (MSW) required
A minimum of 2 years’ experience working with behavioral health clients providing direct evidence-based assessment, diagnosis formulation, treatment planning, treatment intervention and education to patients and/or family members required
A minimum of 2 years’ experience in a behavioral health primary care setting preferred
Licensed as a Clinical Social Worker (LCSW) required
Registration in State of employment may be required, if applicable, LCSWs must be compliant with their state mandatory laws of LCSW licensure renewal by participating and receiving their continuing education hours yearly
PAY RANGE:
$64,583 - $92,262 SalaryThe posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
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We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.
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