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Utilization Management Social Worker, Facility Based

Date: 07/21/2014

Description: Under the direction of the UM Clinical Supervisor and in coordination with the Director of Health Services, the U.M. Social Worker will plan and implement medical social service delivery programs, promote coordination, continuity of care, and quality management in support of KHS members. The Social Worker will work, in conjunction with the UM Case Manager, to evaluate the appropriate level of care and formulate a safe discharge plan using established criteria and Plan benefit guidelines. The Social Worker will create and review reports to identify inappropriate use of services, to identify a corrective action plan and work with the member to assist in compliance with that plan. 

Requirements:Masters of Social Work degree from an accredited college/university. Two (2) years of experience in the Social Worker field, preferably a background in the medical social work.  Demonstrated experience in social work including interviews, assessments, problem identification/resolution, appropriate documentation and crisis intervention.  Must have Excellent written, verbal and interpersonal communication skills required.  Applicants should be able to demonstrate knowledge and experience of managed care systems.  Have demonstrated skills in coordination and problem solving with members and providers.  Possession of valid driverís license and proof of State required auto liability insurance, occasional travel required.

Applicants should be able to demonstrate knowledge and experience of managed care systems.  Have demonstrated skills in coordination and problem solving with members and providers.  Possession of valid driverís license and proof of State required auto liability insurance. Required travel up to 10%

Req# 095-13