Care Manager – Social Worker

🕒 July 29

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 23%

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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Monogram Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2019

💼 Consulting

🛡️ Insurance

📦 Logistics

Consulting • Insurance • Logistics

Monogram Health is a leading multispecialty provider that delivers in-home, evidence-based care and benefit management for patients with complex, multiple chronic conditions, with a strong focus on chronic kidney disease and related metabolic, cardiovascular, pulmonary, and behavioral health needs. The company coordinates multispecialty clinical teams (nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care), provides 24/7 home-based support including home dialysis and medication management, and partners with payers and physician groups to improve outcomes, reduce hospitalizations, and lower costs.

📋 Description

• Perform in-home and telehealth care management visits to assess and determine social and behavioral status • Work closely with the Care Team to ensure collaboration and optimal patient outcomes • Assess social determinants of health needs and develop plans to address them • Identify, vet, and build relationships with local Community-Based Organizations • Educate patients on appropriate resources, assist with referral completion, and follow up for closure outcomes • Serve as subject matter expert on social determinants for other Care Team members • Complete behavioral, environmental, and social support assessments • Deliver individual, family, and group education on living with chronic illness • Engage family and social support groups in patient education and care • Assess patients and refer them to behavioral health specialists when diagnosis and treatment are needed • Help patients understand, accept, and follow medical and lifestyle recommendations • Review and document patient updates and progress in the care management platform • Practice with a high degree of autonomy as part of integrated, multidisciplinary, home-based care teams • Work face-to-face, by phone, and through telehealth with patients

🎯 Requirements

• Active, unrestricted LCSW license in the state of employment • Social workers requiring ongoing clinical supervision to practice independently, including those at the master's or associate level pursuing full licensure, are not eligible • Basic Life Support (BLS) certification is required; the company will support certification completion through onboarding • Currently licensed as a LCSW in the posted state • Master's degree in social work • Passed ASWB master's or clinical exam • Ability to work independently with minimal supervision • Ability to show empathy and quickly build relationships with patients and local CBOs • Preferred: 2+ years previous experience working in care management and/or with chronic illness • Excellent verbal communication skills both in person and on the phone • Familiarity with Microsoft Office and mobile phone and web-based applications • Telephonic visits with some car travel to patients' homes • Rare domestic travel may be required to Brentwood, TN

🏖️ Benefits

• Remote opportunity with some occasional local travel • Full benefits package including medical, dental, vision, life insurance, 401(k) plan with matching contributions, paid vacation and holiday time • Company support for BLS certification completion through onboarding