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Utilization Management Social Worker
Date: 08/22/2014

Description: Under the direction of the Manager of Case Management and the Director of Health Services, the Social Worker will plan and implement medical social service delivery programs, promote coordination, continuity of care, and quality management in support of KHS members. This position serves as a liaison to all KHS staff, providers, and  members to provide any social service needs identified for KHS membership. This position is responsible for assigned social work case management functions for KHS, a licensed health maintenance organization (HMO). The primary duty of the Social Worker is to identify and assist members that are displaying a complex variety of social and or emotional needs and usage of services reflective of abuse, lack of compliance to medical or pharmaceutical instructions, or self]destructive habits. The Social Worker coordinates with these members and the memberfs PCP in an effort to provide better medical management and to track and gauge the effectiveness of that effort.

Requirements: Bachelor of Social Work degree from an accredited a college/university. MSW or LCSW preferred. 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. 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 driverfs license and proof of State required auto liability insurance, occasional travel required.

Req#152-14