Job Title: Social Worker
Profession: Specialist
Specialty: Staff Augmentation
Duration: 13 weeks
Shift: Day
Hours per Shift: 8:00 AM - 8:00 PM
Experience: Minimum Years of Experience Required
License: Active license to practice in the State
Certifications: Master Social Worker (LMSW) or Clinical Social Worker (LCSW)
Must-Have:
- Critical thinking skills
- Technological skills including use of databases, Microsoft Office, and electronic systems
- Ability to produce professional reports and letters
- Research and analysis capabilities
- Strong oral and written communication skills
- Personal planning, organization, and time management skills
- Experience in medical chart review
- Decision-making skills
Description:
This position is responsible for conducting quality of care investigations.
These investigations are in line with specific guidelines and protocols.
The role involves assessing member-centric and systemic quality of care concerns.
The objective is to ensure the health and well-being of all members.
Investigation tasks should be thorough, timely, and member-centric.
Corrective action plans must be developed and executed using a standardized process.
It is essential to make appropriate referrals to oversight and regulatory agencies.
The social worker will maintain comprehensive case records to support the investigation process.
Documentation to support quality of care investigations must be collected and maintained.
Cases may be elevated to supervisory staff as necessary.
This position will primarily operate remotely, with occasional in-person requirements based on business needs.
Work hours will generally consist of 40 hours per week.
Anticipated case assignments will occur between 8 AM and 8 PM, including weekends and holidays.
Each case review may take 1-3 hours, with a required turnaround time of 48 hours for documentation.
Familiarity with standardized review frameworks and ECR-specific training is essential.
Training will be provided if needed for specific assessment tools.
Candidates must comply with all required training procedures.