What are the responsibilities and job description for the Insurance Social Worker/Case Manager position at Deptford Center?
Deptford Center is hiring an Insurance Social Worker/Case Manager!!
Job Summary:
The Social Worker / Case Manager in an insurance setting is responsible for coordinating care, assessing client needs, and advocating for appropriate healthcare services for insured members. This role blends clinical social work expertise with case management practices to support cost-effective, quality care. The position ensures members receive necessary healthcare services while navigating insurance benefits, addressing psychosocial needs, and working closely with healthcare providers, payers, and community resources.
Key Responsibilities:
- Assess and manage members’ physical, psychological, and social needs through phone or in-person evaluations.
- Develop and implement individualized care plans focused on achieving optimal health outcomes.
- Collaborate with medical professionals, insurance teams, and community agencies to coordinate services and resources.
- Monitor and evaluate the effectiveness of care plans and adjust as needed.
- Provide guidance on insurance coverage, benefits, and prior authorization processes.
- Support members and families in crisis situations, offering referrals to behavioral health, substance use programs, or housing services as needed.
- Document case activities in compliance with organizational and regulatory standards.
- Participate in interdisciplinary case rounds and quality improvement initiatives.
- Ensure compliance with HIPAA and other applicable laws and regulations.
Qualifications:
- Education: Bachelor's or Master’s degree in Social Work (BSW or MSW) required. Licensure (e.g., LCSW, LMSW) preferred, depending on state requirements.
- Experience: Minimum 2–3 years of experience in healthcare, insurance, or case management settings.
- Certifications: Case Management Certification (CCM) preferred or required within a specified time.
- Skills:
- Strong clinical assessment and critical thinking skills.
- Knowledge of insurance policies, benefits, and utilization review practices.
- Excellent communication, negotiation, and advocacy skills.
- Proficient in electronic medical records (EMR) and case management software.
- Ability to work independently and as part of an interdisciplinary team.
About us:
Deptford Center for Rehabilitation and Healthcare is a 240-bed rehabilitation and skilled nursing facility located in Deptford, New Jersey. Our size enables a warm, nurturing environment, which allows each resident to maintain his or her individuality. Our staff is committed to ensuring the highest quality of life for all our residents, by maintaining each resident’s dignity and independence. We offer a friendly working environment, excellent compensation, great benefits package, professional growth & stability, innovative training programs and more. Deptford Center is a proud member of the Centers Health Care Consortium.
Equal Opportunity Employer –M/F/D/V