Social Worker (LTSS Emergency Department Program)

CalOptima Health is seeking a highly motivated an experienced Social Worker (LTSS Emergency Department Program) to join our team. The Social Worker for Long Term Services Supports (LTSS) Emergency Department Program will provide care coordination for members who are discharging from assigned hospital emergency departments and enrolled in one or more of the LTSS Programs. The incumbent will be embedded in the assigned emergency department 80-90% of the time. The incumbent will collaborate with the appropriate CalOptima Health departments, LTSS representatives and other health care professionals to coordinate referrals and benefits for CalOptima Health and the health networks. The incumbent will assist in facilitating collaboration of other departmental representatives and may be a part of the Interdisciplinary Care Team (ICT) for Community Based Adult Services (CBAS), Long-term Care (LTC), Multi-purpose Senior Service Program (MSSP) and/or In-Home Supportive Services (IHSS). The incumbent will obtain and review completed LTSS assessments, which include but are not limited to MSSP, CBAS and IHSS, and provide coordination of care and referrals to other community-based services.

Position Information:

• Department: Long Term Care
• Salary Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192)
• Work Arrangement: Community Worker

Duties & Responsibilities:

• 85% - Care Management
• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Provides education to members, families and providers about the LTSS programs.
• Participates in hospital and emergency department rounds.
• Collaborates with hospitals and emergency departments on complex discharges.
• Participates in discharge planning for LTC members who may be discharging to the community or CalOptima Health members who may be discharging from hospitals to LTC nursing facilities; discharge planning may include services for CalAIM, transportation, pharmacy, primary care physician (PCP) appointments, community resources, social determinants of health (SDoH) assessments, LTC, MSSP and CBAS.
• Obtains LTSS member assessments and care plans.
• Shares with health networks and managed care plans for the assigned population in accordance with the department's protocol.
• Documents all contacts and case information in the appropriate Zeomega Jiva care management system in Utilization and Case Management modules, using standard charting formats.
• Participates in the ICT meetings; assists with evaluations and investigations, provides recommendations for cases, updates members' healthcare needs and maintains documentation to demonstrate activities of the ICT.
• Works with assigned LTSS representative to ensure the member's right to self-direct.
• Develops and maintains network of current community resources and services where CalOptima Health members can be referred for assistance.
• 10% - Administrative Support
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Retrieves and monitors incoming inquiries from various sources (i.e., Zeomega Jiva care management system, email, etc.).
• Participates in training of internal staff and works collaboratively with other CalOptima Health departments to meet member's needs.
• Acts as a liaison between the LTSS department and other CalOptima Health departments to assist with issues, concerns and inquiries.
• Ensures confidentiality of all protected health information (PHI).
• 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

• Master of Social Work required.
• 3 years of clinical experience working with the needs of seniors or persons with disabilities (SPDs) in a customer/member service capacity required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• A valid driver's license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office approximately 95% of the time.

Preferred Qualifications:

• HMO, Medi-Cal, Medicare, case management and health services (hospital) experience.
• Experience performing psychosocial assessments.
• Experience working with members in a multi-disciplinary care team setting.
• Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese).

Required Licensure / Certifications:

• N/A

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

To apply and see full details, please visit: https://apptrkr.com/5508109