Director of Social Work

Director of Social Work

Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles with Well Med, part of the Optum family of businesses. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Join us and discover the meaning behind Caring. Connecting. Growing together.

The Director of Social Work is responsible for successfully planning, organizing and directing Enterprise operations for outpatient Social Work and Behavioral Health within Care Management. The Director coordinates duties with appropriate personnel to meet operational program needs, ensures compliance with state and federal health plan requirements, Medicare guidelines and NCQA standards; develops and implements policy and procedures; updates and integrates current practice guidelines;

performs employee counseling, performance appraisals, and oversees employee training and development. The success of this position requires the ability to foster communication and teamwork between social worker teams, physicians and staff, market care management teams, corporate departments, vendors, and senior leadership. The position directs long-term planning and regarding Social Work and Behavioral Health and acts as a resource to all internal and external customers.

This position is responsible for oversight and evaluation of all Care Management Social Work and Behavioral Health programs. The Director will report to the Vice President of Care Management and will assist senior leadership with long-term planning initiatives to maintain operations assuring activities are appropriately integrated into strategic direction, as well as the mission and values of the company.

Primary Responsibilities:

• Accountable for end-to-end social work/behavioral health processes
• Oversees social work functions and ensures compliance with approved guidelines, government mandated regulations and contractual agreements to include NCQA, URAC and CMS
• Manages a team of Licensed Social Work/Behavioral Health Managers providing direction to ensure effective management and support of SW/BH staff
• Develops functional, market level, and/or site strategy, plans, production and/or organizational priorities
• Identifies and resolves technical, operational and organizational problems outside their own team
• Responsible for product, service or process decisions likely to impact entire functions and/or customer accounts (internal or external)
• Provides leadership to and is accountable for the performance of managers and/or senior level professional staff
• Review and Implement Social Work protocols for staff oversight and development
• Leverage clinical acumen to provide guidance to staff
• Assist staff in navigating the medical management system
• Provide oversight and review of coordination of care
• Ensure employees are current with clinical licensure and certifications
• Develop/oversee/deliver operational or technical training
• Fosters leadership skills for supervisor positions to ensure aligned management of staff to include the development of future leadership candidates
• Plan, implement, and manage Social Work/Behavioral Health/Community Health worker programs.
• Develop policies, procedures, and guidelines for program
• Review/approve policy and process changes
• Evaluate regulatory changes and determine steps needed to implement in program
• Identify and implement business development opportunities to support growth program
• Oversee/navigate technology applications utilized in the delivery of program
• Intervene in resolution of member or employee complaints or issues as necessary
• Create and implement a business continuity plan to minimize interruptions to the business
• Promotes communication to members by informing them of updates and revision in policies, using training or orientation opportunities, newsletters, or other available resources such as forum presentations
• Cultivates relationships with internal and external groups in support of member education and knowledge sharing
• Ensure compliance of Social Work Program and services
• Interpret compliance/clinical/medical reports
• Evaluate compliance with Federal, State, and Local regulatory and organizational guidelines
• Evaluate programs and services against accreditation standards and contractual requirements
• Oversee ongoing monitoring and internal auditing against relevant guidelines and standards Implement process improvement activities to address areas of non-compliance or ensure procedures are followed
• Measure employee/provider performance against internal procedures and protocols
• Ensure team members address gaps in performance against internal procedures and protocols
• Monitor and evaluate employee performance and productivity
• Develop operations program goals
• Develop and communicate performance metrics and expectations
• Direct data collection and measurement of outcomes
• Apply metrics to evaluate services, employee performance, and program outcomes
• Identify causes of performance deficiencies and determine…