BSW Program Specialist Social Worker

McAllen, TX

Posted: 05/14/2024 Category: Social Worker Job Number: smanzella117314

Job Description

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!

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About McAllen, TX

Unlock your next career opportunity in the vibrant city of Mcallen, Texas! Embrace a dynamic job market set against the backdrop of a growing community with endless possibilities for professional advancement. From savoring authentic Tex-Mex cuisine to strolling through the historic La Plaza Mall or catching a show at the beautiful Mcallen Performing Arts Center, this charming city offers a unique blend of culture and opportunity. Explore job listings in this bustling area, known for its lively arts scene, proximity to the stunning Bentsen-Rio Grande Valley State Park, and the excitement of supporting local sports teams like the UTRGV Vaqueros. Discover your career potential in Mcallen, where every day brings new adventures and growth.