Program Specialist 1- Social Worker

Job Description:

Job Title: Program Specialist 1 Social Worker

Location: Remote role

Duration: 8 months (Possible extension)

Shift: MonFri 8 am 5 pm 8a 5p MF 9a 6p Saturdays (alternating approximately every other weekend) ***includes holidays

Job Summary:

• Conduct screening and risk assessment interventions per program guidelines.
• Assist with nonmedical aspects of the members care including referrals to community resources.

Walk me through the daytoday responsibilities of this the role and a description of the project (

• Healthy Opportunities (HOP) Eligibility & Enrollments Benefits Eligibility Screenings Cold Calls Assistance in phone queue.

Productivity Expectations:

• HOPrelated tasks and correlating average processing times. Required to meet/exceed the minimum 6.5 hrs. of daily completed work.

Task: Average Processing Time

Assessments < 20 minutes

Eligibility/Enrollments < 30 minutes

Service Authorizations/Disenrollments < 7 minutes.

2day followups < 5 minutes

Productivity logs should reflect 6.5 hrs. per day of completed work.

For example:

Task Calculation HH:MM

(8) Eligibility/Enrollments 8x30/60 4

(6) Assessments 6x20/60 2

(6) 2day followups 6x5/60 0.5

Total 6.5

Job Responsibilities:

• Healthy Opportunities (HOP) Eligibility & Enrollments Benefits Eligibility Screenings Cold Calls Assistance in phone queue.
• Identify special needs members through the completion of health screens and other resources.
• Work with community outreach/member advocates to coordinate member care.
• Educate providers and community resources on program components and available support services.
• Educate members with special needs to foster compliance with program and positively impact outcomes.
• Conduct site visits as appropriate for programs and provide support to other special programs.
• Develop and modify care plans in conjunction with members members family and managing physician.
• Development of plan specific literature and education materials in conjunction with medical director and corporate oversight.

Minimum Qualification:

• Bachelor/masters in social work.
• Proficient with excel/word.
• Experienced MSW/SW in a healthcare/community setting.
• Community work experience with closing SDOH needs.