Role Overview:

Provides Quest Integration (QI) care coordination for members with special health care needs, utilizing face-to-face/in-home Health Functional Assessments (HFA). Develops client-focused service plans collaboratively with primary care physicians and decision makers. Assists with access to medical care, services, and coordinates Home Community Based Services (HCBS) as needed. Communicates with care teams, community agencies, and families to ensure comprehensive care.

Key Responsibilities:

Performs comprehensive assessments and creates service plans within 15 days of notification. Maintains documentation in electronic health records, tracking assessments, care, and progress. Provides resource referral services for dental, behavioral health, social services, and protective services. Acts as a resource for members, families, providers, and community organizations regarding healthcare and services. Collaborates with Member Care Services to navigate HCBS, supplies, and equipment. Conducts social work consultations and develops community resources.

Qualifications:

Minimum one year of social work experience or six years of related field experience. Master's degree in social work or equivalent experience. Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW). Basic Life Support certification.

Skills & Preferred Experience:

Strong communication, problem-solving, teamwork, documentation, and interpersonal skills. Experience in care coordination/case management, home health, or working with medical diagnoses is preferred. Ability to network with community agencies and develop community resources.