This position is responsible for working closely with the Health Services team and directly with members to assist with psychological and social care coordination needs.
Responsible for the member-centered assessments/reassessments, covering psychosocial, rehabilitation, and environmental concerns
Based on needs identified in an assessment, arranges, coordinates, and monitors services from different providers to serve member needs
Conduct follow-up; monitor member’s needs and care plan; identify and develop support system for the member
Assist CCS members and their families with transition care planning from age 16 until 21 when members age out of CCS
Evaluate the potential member as a total person and identify the functional limitations that impede independent living
Provide resources and linkages to crisis management
Develop individualized, member-centered care plans
Consult with the Nurse Care Manager as warranted on medical issues
Refer members to specialized programs, such as TCRC, ADMHS, Public Health
Consult and cooperate with community systems to facilitate linkage, referral, advocacy, and follow up with the focus on attaining care plan goals
Recommend improvements for the member’s functional level
As necessary, perform home visits to ascertain home situation
Maintain an active caseload providing interventions as needed within area of expertise and limits
Maintain a high level of ethical conduct and adhere to HIPAA and confidentiality regulations
Participate in continuing education activities, remaining knowledgeable in area(s) of expertise
Participate in CCS Medical Therapy Unit Conferences and address identified psycho-social issues of members and their families
Other duties as assigned
Demonstrate expertise and ability to function as a care manager as evidenced by experience
Ability to clearly and effectively communicate and negotiate with members and families, physicians, and other health care providers
Self-motivated to seek knowledge in order to improve personal and professional performance
Bilingual Spanish – written and oral
Ability to work effectively in a cross-functional team environment
Strong computer literacy and skills
Excellent verbal communication and writing skills required
Knowledge of existing community resources and ability to effectively link members to agencies
Experience with providing services and addressing problems of children and young adults with disabilities and special healthcare needs
Minimum of one (1) year in a managed care or health plan setting, Medi-Cal or Medicaid preferred
Minimum of one (1) year in case management and care coordination preferred
Experience in developing member centered individualized care plans
Requires a minimum of a Master’s degree in Social Work, Clinical Psychology, or Psychology. A concentration in Gerontology, Pediatric, Public Health, Substance Abuse, Mental Health or other related fields is preferred
Requires a minimum of five (5) years of clinical work experience in the above field.
Licensed Clinical Social Worker license substitutes for two years of work experience
About CenCal Health
CenCal Health is a publicly-funded managed care organization that provides health care coverage for residents in Santa Barbara and San Luis Obispo counties.
