BSW Program Specialist Social Worker
McAllen, TX US
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!