Social Work Care Manager

Job Summary

Responsible for collaborating with the members of the health care team to facilitate the coordination of appropriate, cost‑effective services that are consistent with members plan of care to help achieve their optimal level of independence and enhance quality of life.

• In close collaboration with the member/members family, and members of the health care team, assess the members health status, functional limitations, psychological status, social support systems, resources, environmental factors, and response to treatment.
• Use motivational interviewing techniques to identify members readiness for change, create an appropriate care plan based on assessments, assist member with health system navigation and connection to community resources.
• Provide supportive counseling and education to members, families and caregivers, members of the health care team, and others including end‑of‑life issues and Advance Directives.
• Effectively manage and coordinate assigned caseload consistent with established criteria. Ensure consistent and reliable documentation of case management activities in compliance with all organization and department standards.
• Facilitate application process for accessing local, state, and federally funded programs (e.g., Medicaid, Medicare, Disability) and/or refer to appropriate community resources.
• Coordinate care across the care continuum for members receiving behavioral health and substance abuse services.
• Responsibilities include, but are not limited to, problem identification, psychosocial assessment, financial counseling/referral, accessing community resources, placement for care, guiding the member through health‑related legal processes, or consultation and support to other health care professionals.

Requires 1 year experience working directly with individuals with Substance Use Disorder and youth with a mental health diagnosis.

• Minimum two (2) years of experience in case management or three (3) years of clinical experience.
• Minimum one (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria:
  • Individuals involved with Child Protective Services, foster care, and/or former foster youth
  • Individuals with Substance Use Disorder
  • Youth with a mental health diagnosis

• Master’s degree in social work (MSW) required.

• Credentials from multiple states: primary work state required at hire; additional secondary state credentials required post‑hire.
• Independent Clinical Social Worker License (District of Columbia) within 6 months of hire.
• Licensed Clinical Social Worker (Virginia) within 6 months of hire.
• Licensed Clinical Social Worker – Certified (Maryland) within 6 months of hire.

• Must have reliable transportation and be able to complete in‑person assessments in the home and community (For anyone hired after April 1, 2025).
• Exceptional oral and written communication skills to interact with diverse members and providers and present care plan.
• Exceptional listening skills to assess needs and identify problems.
• Cultural humility to appreciate unique perspectives, backgrounds, and differences.

• Case Manager Certificate (CCM) preferred.
• Pediatrics:
  Minimum one (1) year of recent experience with pediatric/adolescent population preferred.
• Perinatal:
  Minimum one (1) year of recent experience with recent labor and delivery of predominately high‑risk obstetrics or perinatal population preferred.
• Renal:
  Minimum one (1) year of recent experience with nephrology or renal population preferred.