More jobs:
Social Worker- Pilot CCM
Job in
Brookfield, Fairfield County, Connecticut, 06804, USA
Listed on 2026-09-21
Listing for:
ROMTech
Seasonal/Temporary
position Listed on 2026-09-21
Job specializations:
-
Healthcare
Patient/Health Advocate, Community Health
Job Description & How to Apply Below
Having created this new lane, we have a unique opportunity to serve as the global leader in the business, technology, and science of recovery, and to bring life-changing help to many millions of people.
Job Purpose The Contract Social Worker supports the Chronic Care Management (CCM) program by providing psychosocial assessments, care coordination, and resource navigation for patients with chronic and complex conditions. This role contributes to improved patient outcomes, adherence to care plans, and reduced barriers to care by addressing social determinants of health and connecting patients with appropriate services. The position supports interdisciplinary collaboration and ensures alignment with CMS CCM guidelines and organizational care delivery objectives.
This position is based out of Florida. An Active Florida Social Work License is required.
Key Responsibilities Essential Duties Conduct psychosocial assessments to identify patient needs, barriers to care, and social determinants of health
Collaborate with interdisciplinary care teams to support development and execution of individualized care plans
Provide short-term supportive counseling and emotional support to patients managing chronic conditions
Identify and facilitate access to community-based resources including housing, transportation, food assistance, behavioral health, and financial services
Support patient adherence to care plans and medication regimens through education and structured follow-up Assist with care transitions, including post-discharge coordination and patient support
Maintain accurate, timely, and compliant documentation in EHR and CCM platforms
Participate in case consultations or interdisciplinary discussions as needed to support patient outcomes
Ensure all activities align with HIPAA and CMS Chronic Care Management guidelines
Other Functions Participate in program improvement initiatives or workflow optimization efforts as mutually agreed
Support onboarding or knowledge-sharing activities related to CCM services if applicable
Performs other mutually agreed upon duties consistent with the applicable engagement or contract JOB QUALIFICATIONS
Skills and Abilities
Required:
This position is based out of Florida. An Active Florida Social Work License is required.
Strong understanding of social determinants of health and care coordination principles
Excellent communication and interpersonal skills for patient engagement
Ability to work independently and manage caseloads in a structured, outcome-focused manner
Strong organizational and documentation skills
Ability to navigate community-based resources effectively
Preferred:
Experience in chronic care management or population health programs
Familiarity with telehealth platforms and EHR systems
Bilingual (English/Spanish)
Work Experience Requirements
Required:
2–3 years of experience in care management, medical social work, or chronic disease management
Preferred:
Experience working with Medicare or high-risk patient populations
Background in behavioral health, geriatrics, or case management
Education Requirements
Required:
Bachelor’s or Master’s degree in Social Work (MSW strongly preferred)
License and Certification Requirements
Required:
Active Florida Social Work License (externally…
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