Case Manager - Social Worker

Pay Range:

Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

At BCBSRI, our greatest resource is our people. 

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.

We recognize that to do your best work, you have to be your best self. 
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.

Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.

Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. 

We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

Why this job matters: 

Serve as the team’s expert in community-based resources and assist the beneficiary and/or caregiver in working towards goals related to accessing community services and applying for additional programs and benefits. Assess the beneficiary’s home environment as needed. 

What you will do:

• Conduct assessments, which include identification of member’s internal and psychosocial strengths and coping strategies.  Develop, implement, and monitor individualized care plan goals. Identify and utilize external, cultural, familial and community resources. 
• Act as advocates, coordinators, and supporters for individuals and care takers in need.
• Utilize a multidisciplinary team approach to address opportunities, evaluate progress and identify resources.
• Communicate with all care team members, including physicians, to report patient progress, needs, and concerns. Maintains accurate and timely records including progress notes according to department policy.
• Improve quality of life by assisting members in achieving an optimal level of wellness. Promote independence through education, advocacy, and empowerment to make informed decisions.  Identify external resources as well as barriers to care, access, and treatment adherence.
• Conduct home and community visits to help evaluate and promote member safety and/or assist with application processes.
• Provide resources for members experiencing adjustment to illness, life transitions, grief, need for advanced care planning, and others
• Develop working relationship with local community resource groups, representing BCBSRI at meetings and activities that address the social needs of members (e.g. Community Action Programs, Office of Healthy Aging, etc.)
• Participate in the development of special projects, facilitate meetings in the community or at the Blue Store, and quality improvement activities.
• Assist members as needed with Housing Applications, LTSS applications
• Perform other duties as assigned.

What you’ll need to succeed:

• Bachelor’s degree in social work, or an equivalent combination of education and experience
• Three to five years’ experience working with vulnerable populations
• Optional: Master’s degree in social work (MSW) and Rhode Island Licensed Certified Social Worker (LCSW) licensure
• Experience working in a managed care/health maintenance organization
• Experience in specialties such as geriatrics and chronically ill clients preferred, knowledge of health care plans and benefits
• Understanding of health care delivery system access points and services
• Ability to navigate the healthcare delivery system
• Excellent verbal, written communications and technical skills
• Negotiation skills
• Presentation skills
• Decision-making skills
• Good problem-solving skills
• Ability to interface with employees at all levels
• Ability to effectively navigate ambiguous situations with limited direction
• Excellent organizational skills and ability to successfully prioritize multiple tasks
• Ability to handle multiple priorities/projects
• Strong time management skills
• Crisis de-escalation skills
• Bilingual preferred

Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
   

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.

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