Social Care Manager-North Country

About the role

The Social Care Manager is the direct point of contact for Medicaid Members with ongoing HRSNs and is responsible for conducting their eligibility assessments for enhanced HRSN services, as well as development of social care plans.

Responsibilities

• Manage incoming referrals for enhanced HRSN services to ensure successful and timely connections are made for community members.
• Provide longitudinal care management for Members receiving one or more enhanced HRSN service.
• Conduct and document outreach to community members in alignment with required frequency, modality, and timeframe.
• Manage Member consent and attestation as required throughout the screening, assessment, and care management process.
• Conduct HRSN screening using the Accountable Health Communities (AHC) screening tool to assess member HRSNs.
• Conduct eligibility assessments to determine Member eligibility for enhanced HRSN services and refer Members to eligible programs and services, including enhanced HRSN services and/or existing federal, state, and local resources.
• Develop social care plans that include a summary of Member needs, eligibility, and services to which they are referred.
• Ensure referrals are acted upon by HRSN service providers within required timeframes and redirect as necessary to support service connection. Document progress notes and action taken with each referral, as detailed in the Network Standards and Quality Program.
• Update the social care plan throughout service provision in collaboration with the Member and service provider to reflect strategies and interventions for meeting identified HRSNs.
• Monitor and manage eligibility status changes in collaboration with Eligibility Specialists and enhanced HRSN service providers.
• Confirm service delivery completion and that Member needs have been addressed satisfactorily and support the transition to additional resources.
• Regularly use data and data tools to report referral patterns and trends to the management team.
• Share detailed feedback on successes and challenges of the role with the Referral Coordination Manager and continually look for opportunities to enhance and simplify the community member experience.

Requirements

• Education: Associate degree in health, social services, or related field preferred. Equivalent work experience in a related field may be considered in lieu of degree requirements.
• Professional work experience: Minimum of 5+ years related experience in a clinical, non-profit, or Managed-Care Organization (MCO) environment preferred.

Skills

• Extensive knowledge and understanding of health equity, social drivers of health, and social care data.
• Excellent communication and presentation skills.
• Experience using translation services preferred.
• Ability to build collaborative working relationships with others inside and outside the organization through cooperation, mutual respect and capacity to inspire and motivate others.
• Thriving working with multiple systems and processes.
• Demonstrated ability to use various technology platforms to ensure successful and timely referral connections are made.
• Effectively working in a hybrid work environment. Some local travel may be required for meetings, community events, and other job-related responsibilities.
• Demonstrated commitment to the values of diversity, equity, and inclusion.
• Extremely detail-oriented and capable of multitasking.
• Proven record of hitting key metrics, defining effective data-driven network development strategies, and problem-solving.
• Proficient computer skills and willingness to learn additional software applications.
• Demonstrated ability to thrive in a demanding environment.

Benefits

Competitive compensation package
Comprehensive insurance benefits available the 1st of the month after hire, including but not limited to medical, dental and vision, group short-term disability and life insurance with buy-up options, flexible spending and HSA company-contributed accounts, and more
401K with a company match
Unlimited paid time off after 90 days of employment
Company-sponsored training and certification opportunities
Remote employer with flexible work schedules
A workplace that values safety, respect, employee engagement, recognition, and diversity

Pay

$52,950-$60,982 per year, commensurate with experience

Schedule

Full time