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Applicants must be eligible to begin work on the date of hire. Applicants must be currently authorized to work in the United States on a full-time basis. ARKANSAS BLUE CROSS BLUE SHIELD will NOT sponsor applicants for work visas in this position.
Arkansas Blue Cross is only seeking applicants for remote positions from the following states:
Arkansas, Florida, Georgia, Illinois, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, Virginia and Wisconsin.
Job Summary
The Licensed Masters Social Work Case Manager will work in the Clinical Services and Population Health area. The LMSW Case Manager is responsible for providing support activities for members. This includes significant coordination with all departments as well as providers and community based organizations to promote effective, efficient care.
Requirements
EDUCATION
Master’s degree in Social Work.
LICENSING/CERTIFICATION
Licensed Master Social Worker (LMSW) with current active state license in good standing in the state(s) where job duties are performed required.
Case Management Certification required. If certification is not obtained prior to employment, must test successfully within three (3) years.
Valid Driver's licenses.
Arkansas Licensed Clinical Social Worker (LCSW) preferred.
EXPERIENCE
Minimum two (2) years' clinical practice experience in direct clinical care with patients in a hospital, facility or community-based environment.
Minimum two (2) years' experience in case management, home health, critical care, social work, discharge planning, or utilization review.
ESSENTIAL SKILLS & ABILITIES
Professionalism
Ethical Practice
Critical Thinking and Professional Judgment
Embrace Diversity
Advance human rights and socioeconomic justice
Excellent verbal and written communication skills
Proficiency using basic computer skills in Microsoft Office such as Word, Excel, and Outlook, including the ability to navigate multiple systems and keyboarding.
Ability to make sound judgements and decisions based on facts and guidelines.
Ability to build collaborative relationships.
Attention to details.
Ability to interpret complex documentation.
Ability to work independently with little supervision.
Skills
Active Listening, Analytical Problem Solving, Collaborative Communications, Critical Thinking, Cross-Functional Planning, Data Analysis, Ethical Standards, Interpersonal Relationship Management, Management Techniques, Microsoft Office, Oral Communications, Problem Sensitivity, Social Awareness, Support Coordination, Written Communication
Responsibilities
Case Management: Assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet an individual’s health needs through the use of plan benefits and community resources to facilitate appropriate cost effectiveness and cost containment measures are met., Communication: Serves as a liaison facilitating a collaborative process to promote quality of care, cost effectiveness, accessibility and appropriateness of service levels., Compliance: Practices within the scope of licensure and adheres to policies, procedures, regulations, URAC standards and individual state regulations; making decisions to ensure compliance, appropriate level of care, and patient safety., Knowledge: Remain current with up-to-date social work licensing requirements and continuing education., Other duties as assigned., Travel: Travel to site or home visits may be required. Valid driver’s licenses is required., Workflow: Proactively work with referrals from multiple sources to identify appropriate candidates for case management, explaining services ensuring voluntary agreement of services and maintaining a minimum patient caseload in a timely matter.
Certifications
Case Manager Certified (CMC) - The Commission for Case Manager Certification (CCMC), Certified Case Manager (CCM) - The Commission for Case Manager Certification (CCMC)
Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.
Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.
Employment Type
Regular
ADA Requirements
2.1 General Office Worker, Semi-Active, Campus Travel - Someone who normally works in an office setting or remotely, periodically has lifting and carrying requirements up to 40 lbs and routinely travels for work within walking distance of location of primary work assignment as essential functions of the job.