Social Work Care Manager 7/27/2018

BMC HealthNet Plan Boston, MA

Boston, MA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Masters Degree




The Social Work Care Manager works collaboratively with the nurse care clinician, behavioral health clinician and/or care coordinator to collaboratively assess the needs of the member and the member s family/caregivers when appropriate, and arranges, coordinates, monitors, evaluates and advocates for services to meet the member s psychosocial needs. The Social Work Care Manager works with the member to increase their capacity for self management and to promote behavioral changes that facilitates short and long term linkages with necessary community, social service, medical or behavioral health resources.

Key Functions/Responsibilities:

* Completes assessments

* Utilizes motivational interviewing techniques, systems theory, change theory, acceptance and commitment approaches, patient activation and psycho-education to engage members in care management

* Supports and enhances the member s capacity to self-manage by detecting underlying mental/behavioral health issue impacting general health.

* Establishes and maintains effective working relationships with members, social service agencies and other members of the interdisciplinary team. Maintains flexibility and adjusts approach to the needs of the team.

* Facilitates member access to psychosocial supports such as

* Adequate Shelter and/or Affordable Housing

* Adequate Access to Food Resources / Food Stamps / WIC

* Transportation Needs / PT1/ Area Public Transportation

* Federal and State Income / Entitlement Programs

* ADL /IADL Support Programs / PCA / Homemaking

* Financial Assistance Programs

* Health Plan Benefits

* Vocational Opportunities

* Family Resources / Furniture / Clothing

* Peer Support Programs

* Behavioral Health / Substance Abuse Referrals

* Job training and interviewing skills

* Assists the member, when necessary, in placing calls, completing applications, and advocating for available supports/services

* General knowledge of the most common conditions presented in the Medicaid population and is able to assess, manage and triage at risk, high needs members.

* Researches and shares community resources with members and peers.

* Contributes to the development of an individual care plan [ICP] for the member

* Provides or arranges for resources necessary to meet members psychosocial needs.

* Promotes and encourages member collaboration with the primary care provider, other health care providers and social service agencies.

* Facilitates interdisciplinary consultation on members behalf through participation in rounds, team meetings and clinical reviews.

* Conducts face-to-face visits with selected members as appropriate.

* Complies with established metrics for performance and adheres to documentation and work flow standards.

* Completes documentation in the medical management information system in a timely manner and in keeping with, internal policy and accreditation standards.

* Appropriately utilizes auxiliary codes per department guidelines.

* Maintains HIPAA standards and confidentiality of protected health information.

* Adheres to departmental/organizational policies and procedures.

* Facilitates member communication with internal partners such Member Services

* Other duties as assigned.

Supervision Received:

* Weekly and on-going from Manager of Care Management



* Masters Degree In Social Work, Psychology, Education, Public Health or a related field required.

Experience required:

* 2 years of experience working with individuals with complex medical/behavioral and/or psychosocial needs.

Certification or Conditions of Employment:

* Active state licensure as a Social Worker or related field strongly preferred.

* Pre-employment background check

Competencies, Skills, and Attributes:

* Strong oral and written communication skills

* Ability to establish and maintain effective working relationships with members, social service agencies, community resources and other members of the interdisciplinary team.

* Ability to work with members to promote positive behavioral change

* Strong Motivational Interviewing skills

* Bilingual desired

* Demonstrated strong organizational and time management skills

* Able to work in a fast paced environment and multi task

* Experience with Microsoft Office application, particularly MS Outlook and MS Word and other data entry processing applications

* Knowledge of medical terminology

Working Conditions and Physical Effort:

* Regular and reliable attendance is an essential function of the position.

* Work is normally performed in a typical interior/office work environment.

* No or very limited physical effort required. No or very limited exposure to physical risk.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. BMC HealthNet? Plan/Well? Sense Plan participates in the E-Verify Program to electronically verify the employment eligibility of newly hired employees.


Boston Medical Center Health Plan, Inc. (BMCHP) is a not-for-profit health maintenance organization founded in 1997 by Boston Medical Center. BMCHP’s Massachusetts business, BMC HealthNet Plan, serves over 260,000 members across the state and offers coverage to New Hampshire’s 115,000 Medicaid managed care program recipients. In New Hampshire, the organization operates under the name Well Sense Health Plan.Healthcare is one of the most dynamic and rapidly growing industries in the U.S. Working at our organization will challenge your knowledge and skills, while providing you with opportunities to participate in training and development programs that will help you achieve your professional goals. Whether it’s your first job or you want to take the next step in your career, we offer many rewarding positions in a welcoming, diverse work environment. Learn more about available job openings today.

Company Size:
501-1,000 Employees
Health Care
Social Media:
2 Copley Place Suite 600
Boston, MA 02116

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