The Medical Social Worker works in conjunction with Care Coordination staff and interdisciplinary team consisting of the medical director, utilization management staff and others involved in the members care in order to meet the global needs of the member and their family. Interventions may include assessing the psychosocial functioning of the member and family, assistance with discharge planning, connecting members and families to necessary resources and supports in the community; arranging psychotherapy, supportive counseling, or grief counseling; or helping a member to expand and strengthen their network of social supports.

• Completes daily case assignments as necessary and documents the plan of care and treatment recommendations in the Care Connect system.
• Conduct member outreach through telephone or virtual face-to-face communication to assess their needs and address any issues or concerns.
• Assess and manage member needs such as complex medical, psychosocial, cognitive and functional conditions.
• Collaborate with other professionals to evaluate members’ psychosocial and physical needs.
• Refer member, or family to community resources to assist in recovery from mental or physical illness and to provide access to services such as financial assistance, legal aid, housing, job placement or education.
• Counsel family members to assist them in understanding, dealing with, and supporting the member or member.
• Identify environmental impediments to member or member progress through interviews and review of member records.
• Utilize consultation data and social work experience to plan and coordinate member or member care and rehabilitation, following through to ensure service efficacy.
• Monitor, evaluate, and record member progress according to measurable goals described in treatment and care plan.
• Supervise and direct other workers providing services to members or members.
• Modify treatment plans to comply with changes in members’ status.
• Other duties as assigned by the Care coordination Manager and the Director of Clinical Services
• Assists the Member Services department as assigned
• Collaborates with facility case managers and physicians to assure their participation and compliance with post discharge arrangements.
• Participates as part of the care management team works collaboratively with all department staff.
• Complies with CCHP Compliance Handbook including Code of Ethics andall statues, regulations and guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statue, regulations, agreements or guidelines applicable to all healthcare programs.
• Accepts and performs other duties as assigned.

• Health plan experience preferred
• Minimum two years acute in hospital, health plan, home health or related experienced required
• Bi-lingual in English and Cantonese required
• Excellent verbal and written communication skills.
• Excellent interpersonal skills
• Able to communicate and collaborate effectively with physicians and allied health care providers
• Strong negotiation skills
• Ability to set and change priorities quickly and as the situation warrants
• Able to work independently and as a team player
• Working knowledge of Word and Excel
• Ability to maintain high volume workload without compromising quality. Expectation to manage a minimum of 100 members at baseline
• Ability to work as a member of a team, assuming different roles as the situation warrants

• Able to lift up to 30 pounds
• Use proper body mechanics when handling equipment
• Standing, walking and moving 50% of the day.