Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Case Manager - Social Worker

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Manager & Professional
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2103C Requisition #
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This position is community-based with responsibilities within both EmblemHealth Neighborhood Care and EmblemHealth’s care management regional teams. The Social Work Case Manager is a specialist who provides case management services for the chronically ill or at-risk population with an overall objective to help member’s live fuller and more meaningful lives. The Social Work Case Manager will assist in managing members with behavioral health, substance abuse, and/or psychosocial conditions/issues, consulting with colleagues across the enterprise. on behavioral health, substance abuse, and/or psychosocial issues. As a behavioral health specialist, the Social Work Case Manager facilitates member adoption of strategies to promote physician recommended behavior changes. Social Work Case Managers will help members improve health outcomes and provide feedback to members of the medical and care management care teams.

Responsibilities:

  • Perform member outreach – telephonically and in-person, individual needs assessment, education on early warning signs of disease and disease prevention, and identifying customers in potential need of care. Support services as well as social service supports from other organizations (community based and otherwise).
  • Responsible for managing a caseload of members with behavioral health diagnoses and serving as a consult resource for the integrated care team for all members with co-morbidities to support activities with interdisciplinary care team, ie. Care Specialist, Care Manager, within Regional Model of Care
  • Work within interdisciplinary team of Care Specialists and Care Managers to complete health assessments and individualized Care plans
  • Assists members with the coordination of services from various settings as appropriate, includes facilitating discharge from acute setting to home and acute setting to alternate settings. Provides Care Coordination throughout the continuum of care by including the member, member’s family and providers in the process.
  • Assesses members Social Determinants of Health, such as housing, food, transportation and safety in the home and assesses members Mental health needs including PHQ2 and 9 Depression screening, Provides referrals for mental health counseling .- Provides additional appropriate referrals and support as needed.
  • Support activities of other Neighborhood Care team members
  • Participate in all other projects relating to community clinical programming as identified by Regional Manager, Director and AVP in Neighborhood Care,, Care Management and Medical Management Leaders.

Qualifications:

  • Master’s degree in social work with LMSW
  • LMSW required, LCSW Preferred.
  • Bilingual capabilities strongly Preferred.
  • Minimum 4-6 years of direct social work experience. Required.
  • Experience in a managed care setting preferred Preferred.
  • Working knowledge of community health and support services Required.
  • Discharge planning or case management experience preferred. Required.

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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