A-Line Staffing is now hiring a BSW Program Specialist Social Worker with a major health insurance fortune 500 company based in the McAllen, TX area! This would be full time / 40+ hours per week. Starting ASAP!! Apply now with Silvana Manzella at A-Line!

Must reside in the McAllen, TX area for team meetings a few times a year

Bachelor Social Worker Highlights:

• The schedule is Monday - Friday from 8AM - 5PM, Potential OT
• Full benefits available after 90 days include: Medical, Dental, Vision, Life, Short-term Disability
• GREAT Hours! Monday through Friday, 40 hours per week
• 6 month contract with potential to extend

Bachelor Social Worker Compensation: The pay for this position is $22 - $26 hourly based on experience

• Fully remote need to reside in McAllen or surrounding area for meetings a few times a year

Bachelor Social Worker Job Responsibilities:

• Telehealth assessments
• Review assessments & service plans (vendor or internal assessments)
• Follow up on pending assessment findings, clarify DX, reported abnormals, requested referrals, etc.
• Hospital discharges follow up
• MN denials
  • Research community resources.
• 2065D approval/denials
  • Update LTSS
  • Terminate LTSS waiver service authorizations.
  • Provide community resources.
  • Instruct member on appeal process and level change.
• ISP updates (internal), 1700-3 obtain verbal approval and update form, update 1700-2 with waiver items.
• Initiate LTSS/acute services (create authorization request template)
• Research complaints and provide updates to managers for complaint responses.
• Escalations
  • MSC call backs.
• CDS review
• Acute UM denials to include PT denial, request for more information.
• Create clinical reviews/IRTs
• CIC, CIS without MNLOC completion.
• Fair hearing assistance as needed.
• Determine MN for post assessment identified items.
• Dental, nursing, vision, verify service utilization, hearing, 90 day MHM, 28 day follow ups.
  • Verify all services have been started.
  • Follow up on all non DME identified needs.
• Send required referrals for new services/items identified except DME.

Bachelor Social Worker Performance Expectations/Metrics:

• Good attendance and performance - Must have 100% attendance during the first few weeks of training (Start Date likely 6/10)

Bachelor Social Worker Required Skills/Experience:

• Must have a Bachelor Degree in Social Work
• At least 1-2 years of Social Worker experience
• Excellent computer skills; Proficient in Word, Excel, and PowerPoint

Bachelor Social Worker Preferred Skills/ Experience:

• Bilingual in Spanish preferred
• Experience in a managed care environment preferred

If you think this Bachelor Social Worker position is a good fit for you, please reach out to me - feel free to e-mail or apply to this posting!