Social Worker Assistant II

• Support the daily operations of the Virtual Hub by providing program interventions for identified at-risk members under clinical team direction
• Provide administrative support to a clinical team responsible for a defined population of members/beneficiaries
• Process and triage member, caregiver, provider, internal, and external customer calls in a call center environment
• Handle inbound and outbound calls and transactions supporting clinical staff and assigned teams
• Assist with member enrollment in care management programs
• Create, update, maintain, and close tasks; route cases to appropriate Care Coordinators
• Collaborate with members, caregivers, physicians, staff, and health care professionals to provide care coordination
• Implement program interventions, document activities, assist with authorizations, make follow-up calls, and send educational materials and letters
• Help members and caregivers resolve problems and reduce barriers to care
• Identify community-resource gaps and communicate them to the Care Coordinator
• Identify members with Care Gaps/HEDIS-related conditions and assist with scheduling and community-resource referrals
• Reinforce prescribed treatment plans, goals, and strategies to overcome barriers
• Enter timely and accurate data into Care Management applications
• Facilitate access to entitlement programs and community resources
• Attend educational offerings and maintain knowledge of technology, disease self-management protocols, and community resources
• Perform other related duties assigned by clinical staff, Supervisor, Manager, or Director

• Health Science Certification or Associate degree in a health care related field required
• Bachelor’s degree preferred
• Two years of experience working in an office environment required
• Strong organization skills
• Excellent customer service and interpersonal skills on phone and in-person
• Ability to handle multiple tasks simultaneously
• Ability to maintain confidentiality of all company and member information
• Knowledge of medical terminology
• Proficiency working with computers and various computer software applications
• Proficient PC skills in a Windows-based environment, including word processing, spreadsheets, and database programs
• Ability to work Monday through Friday, 8:00 a.m. to 4:30 p.m.

Demonstrates expertise in care coordination, member enrollment, and administrative support within a clinical environment. Proficient in managing member interactions, data entry, and utilizing community resources to enhance patient care.

• Health Science Certification
• Care Coordination
• Customer Service Skills
• Medical Terminology Knowledge
• Data Entry Proficiency

• Care Management Applications
• Task Management
• Community Resource Referrals
• HEDIS-related Conditions Identification
• Program Interventions Implementation

• Strong Organization Skills
• Interpersonal Skills
• Ability to Handle Multiple Tasks
• Confidentiality Maintenance

• Health Science Certification
• Associate Degree in Health Care Related Field

• Clinical Team Support
• Care Management Programs
• Member Enrollment
• Community Resources
• Entitlement Programs

• Windows-based Environment
• Word Processing Software
• Spreadsheet Applications
• Database Programs