Social Work Care Manager

🕒 July 20

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $28 - $53 / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Capital Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1938

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.

📋 Description

• Coordinate services for members meeting established criteria • Educate members, support self-management, and promote quality care and cost-effective outcomes • Assess member needs, review service and resource options, and determine acuity and functional and psychosocial status • Develop, implement, and monitor participant-centered plans of care • Coordinate resources and collaborate with caregivers, providers, community agencies, behavioral health teams, and treatment teams • Evaluate member status and discharge members when criteria are met • Manage and oversee a caseload of moderate- to high-risk members with complex medical, behavioral, and psychosocial needs • Provide counseling and referrals to community, local, and state programs • Serve as a liaison between participants, families, physicians, and treatment-team members • Develop prioritized goals and health actions supporting self-directed care and improved health • Advocate for members and families, helping coordinate care and navigate resources • Obtain required consent forms for program enrollment • Document all care-management activities and outcomes according to policies and procedures • Build member and family relationships and implement interventions supporting improved knowledge, self-management, and long-term care outcomes • Identify and report quality-of-care issues • Maintain member confidentiality • Attend company and departmental meetings and training sessions

🎯 Requirements

• Minimum of 3 years clinical experience in social work counseling with experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background • Graduate from an accredited School of Social Work with an MSW (master’s in social work) degree • Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Certified Independent Practice Social Worker (CIPSW), Licensed Independent Social Worker (LISW), or Licensed Professional Counselor (LPC) • Certified Case Management certification within 2 years of employment • Experience in health coaching and motivational interviewing techniques preferred • Strong communication, written, oral, listening, and organizational skills • Superior clinical process, critical thinking, and problem-solving skills • Ability to use a computer system while conversing telephonically • Strong customer service skills • Ability to prioritize workload and complete duties accurately and timely • Ability to work autonomously and as part of an interdisciplinary team • Proficiency in Microsoft Office products • Knowledge of NCQA, DMAA, CMSA, Act 68, CMS, and ERISA standards and requirements • Knowledge of evidence-based guidelines for chronic conditions and care management • Knowledge of clinical and managed care principles and operations • Knowledge of medical treatment modalities and best-practice guidelines • Knowledge of adult learning principles, motivational interviewing, and intrinsic coaching techniques • Ability to travel using own vehicle to provider, facility, employer group, and/or member locations, if appropriate

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Retirement Plan • Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement • Flexible environment • Training and continuing education • Opportunities to volunteer in the community