Social Worker Care Coordinator—MN Southwest Region

Department:                 Care Management

 

 

 

Reports To:                  SNP Care Coordination Manager

 

 

 

Status:                         Full Time, Exempt

 

 

 

Hours:                          Monday – Friday

 

 

 

Supervision:                This position does not supervise any other staff

 

 

 

Date Updated:              October 31, 2022

 

 

 

Summary:        The Social Worker Care Coordinator is responsible for performing assessments and implementing care management programs that focus on improving the health of individual PrimeWest Health members while reducing health care costs through coordination of health and wellness services provided by PrimeWest Health’s contracted health care providers.

 

 

 

                        After completion of Certified Assessor training, the Social Worker Care Coordinator performs in person assessments and coordinates care for PrimeWest PWSHC and MSC+ members who are eligible for and will participate in long term care, Elderly Waiver services, and/or Personal Care Assistance/Community First Services and Supports. The Social Worker Care Coordinator may additionally conduct health risk assessments and Skilled Nursing Facility assessments for PrimeWests’ PWSHC, MSC+, SNBC, and PHC populations.

 

 

 

                        This position additionally supports county and internal PrimeWest Health staff in the areas of behavioral health, which includes mental health and substance use disorder (SUD) as well as social services and health equity. This individual fosters collaborative relationships with county partners, mental health, special needs and social and community services providers. This individual collaborates with PrimeWest Heatlh Care coordinators and County Case Managers to improve care throughout the health care continuum, supporting all PrimeWest lines of business.

 

                       

 

Reporting Accountability (if applicable) This position is responsible for meeting the following regulatory, contractual, or other requirements on behalf of PrimeWest Health:

 

 

 

1. Knowledge of Minnesota Department of Human Services (DHS), Centers for Medicare & Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA) requirements
2. Knowledge of the following DHS programs and contracts: Families and Children, Special Needs BasicCare (SNBC), and Minnesota Senior Health Options (MSHO)/Minnesota Senior Care Plus (MSC+)
3. Shared responsibility for ensuring compliance with all CMS, DHS, and NCQA rules and regulations in assigned area of responsibility
4. Knowledge of Minnesota Department of Human Services (DHS), Centers for Medicare & Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA) requirements
5. Compliance with DHS regulations regarding assessments, screening, health risk assessments and ongoing Care Management / Care Coordination for members living in PrimeWest’s Southwestern County Region

 

 

Role and Key Responsibilities
Performs the following functions to support the regulatory and contractual requirements on behalf of PrimeWest Health  

 

1. Completes DHS Assessor Training and performs assessment in compliance with the PrimeWest Health / DHS contract and provides Care Management Services Performs in person comprehensive assessments for MSHO / MSC+ members requiring long term care services and elderly waiver services in assigned counties (Southwest region), providing documentation and updates in the MMIS and MnCHOICES systems.
2. Performs assessment via phone, mail or in person for Community Non-Elderly Waiver PWSHC, MSC+, SNBC, and PHC enrollees in assigned counties. Performs annual re-assessments for each enrolled member, offering an in-person option Provides ongoing care management for MSHO / MSC+, SNBC/PHC members enrolled in assigned counties, creating and updating the member’s comprehensive care plan Provides routine Care Plan evaluations to support the changing needs of each member in caseload. Monitors the progress of each member toward achieving health outcomes, evaluating and adjusting timeliness and adequacy of services, as needed. Coordinates individual member treatment plans with a multi-disciplinary team to ensure appropriateness, quality and cost-effectiveness of services provided to members Monitors effectiveness of treatment plans Communicate effectively with the member and other individuals participating in the member’s care plans Works with the member’s interdisciplinary team Builds and maintains positive working relationships with providers, case managers, agencies and services from diverse backgrounds in order to reduce cultural and socio-economic barriers between members and institutions. Assists members with overcoming social drivers and barriers to care Educates each enrolled member about good health practices and behaviors Facilitates primary care provider visits, as well as all preventive and recommended care Arranges and / or coordinates the provision of supports and services identified in the member’s Care Plan, including all necessary services Complies with all requirements of the PrimeWest Health Model of Care Utilizes the MnCHOICES Assessment and Support Plan platform when available

 

General PrimeWest Health Responsibilities

1. Abide by the PrimeWest Health Code of Conduct Comply with all PrimeWest Health policies and procedures Comply with the Health Insurance Portability and Accountability Act (HIPAA) and all other privacy laws Be familiar with building safety procedures and alert maintenance if something requires attention Keep public areas of the department and office neat and clean Conduct other responsibilities and activities as needed and assigned

 

 

Professional Competencies

1. Practice knowledge of clinical standards and outcomes Organizational and time management skills, ability to work effectively with minimal supervision and structure Effective communication and active listening skills Ability to work effectively with minimal supervision Ability to promote member and family autonomy Ability to maintain a calm demeanor when challenged by others or when working in stressful situations Verifiable good driving record and reliable transportation

 

 

Educational Requirements and Required Qualifications

1. At minimum, a BS in Social Work, Master’s Degree and Social Work License preferred. Experience in working with individuals at all stages of life with emphasis on Medicaid, Medicare and Special Needs populations A minimum of 3 years practice as a social worker, with field / community experience preferred. Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Excellent verbal and written communication skills. Ability to sit at a desk or computer station most of the time. Ability to travel 25% to 50% of the time in assigned geographic area

 

 

Appropriate Licensure and Certification Requirements (if applicable)

1. Current and unrestricted license in Social Work strongly preferred                > Must attend DHS Assessor training, maintain certified assessor status, and complete equired continuing education sessions each calendar year Must possess unrestricted driver’s license

 

 

Collaborative Efforts with Other Departments (list all departments this position will be collaborating with)

1. Administration Business IT & Claims Administration Care Management Corporate Compliance & Auditing Information Systems & Technology Member & Provider Services Quality & Utilization Management

 

 

Supervision -N/A  

 

 

 

This position description is not to be construed as an exhaustive statement of essential functions or responsibilities.

 

 

 

 

 

 

 

Kandiyohi or Surrounding area, Minnesota

 

 

 

PrimeWest Health will accept résumés for this position through until filled. No phone inquiries please. Employment to begin ASAP.

 

 

 

Qualified candidates should submit their résumé and cover letter to:

 

 

Attn: Elizabeth Warfield, SNP Care Coordination Manager

 

3905 Dakota Street

 

Alexandria, MN 56308

 

 

 

Or

 

 

 

Email

 

elizabeth.warfield@primewest.org

 

 

 

 

PrimeWest Health is an Equal Opportunity Employer Committed to Diversity, Equity, and Inclusion