Job Description

WellMed, part of the Optum family of businesses, is seeking a CareCoach Connect Social Worker to join our team in McAllen, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live.
As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.
At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
The CareCoach Connect Social Worker is responsible for the assessment, planning, coordination and oversight of services for identified patients. The position identifies, evaluates, and provides management of services for patients with complex, catastrophic, Social Determinants of Health and/or psychosocial issues to promote quality, effective outcomes throughout the care continuum. The position ensures compliance with state and federal health plan requirements, Medicare guidelines and standards. The social worker acts as a liaison to coordinate and collaborate care with physicians, family, and other providers while always remaining an advocate for patients, putting them at the center of care delivery. The Social Worker will interact and engage with others as an interdisciplinary team member.
Primary Responsibilities:

• Performs comprehensive evaluations and documents findings in a concise/comprehensive manner that is compliant with documentation standards for the Center for Medicare and Medicaid Services (CMS)
• Performs patient assessments telephonically, virtually, or in the patient's home as needed
• Understands and plans to assure services provided work within the boundaries of the patient's plan eligibility. Coordinates identified patient's needs utilizing federal, state, and local community resources, as available
• Coordinates with external and internal teams to minimize obstacles and increase in patient and provider satisfaction
• Actively participates in staff and Interdisciplinary Team (IDT) meetings
• Adheres to organizational and departmental policies and procedures
• Maintains a high level of professionalism and adheres to the WellMed Core Values
• Assumes responsibility for personal and professional development
• Ensures licensure, certifications, and annual training are maintained and compliant
• Maintains knowledge of current health plan benefits
• Conducts advanced care discussions with a patients and their families and properly documents their wishes in the electronic medical record
• Exhibits professionalism and is courteous with all patients, physicians and co-workers. Follows CareCoach Connect providers' orders regarding the scope and frequency of services needed based on acuity and patient/family needs
• Maintains a patient case load, daily visits and point of care documentation levels as per standards
• Documents in the electronic health record progress toward established goals as per standards
• Performs other duties as assigned

In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we're making health care work better for everyone.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:

• Bachelor of Social Work with 3+ years of experience beyond the required years of experience
• Current BLS certification or must obtain certification within 30 days of employment hire date
• 3+ years of social work experience in a health care environment
• Proficient in MS Office Suite to include Word, Excel, Notes, Outlook, and other departmental specific programs/applications
• Proven excellent oral and written communications skills
• Proven solid organizational skills
• Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously
• Reliable transportation for daily travel to various locations as assigned
• Valid drivers license within the state of work
• Ability to travel up to 80% around the McAllen, Texas area to meet with members in their homes, the hospital or in a long-term care setting

Preferred Qualifications:

• Masters of Social Work with licensure (LMSW or LCSW or LBSW)
• Experience working with geriatric and behavioral and mental health patient populations
• Long Term Care experience
• Knowledge of disease management, managed care, medical terminology, referral process, claims, and CPT coding
• Bilingual (English/Spanish) language proficiency

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 to $87,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required