Job Description:
***This Position Requires an LGSW or LMSW Social Work License***
Case Manager - DC Medicaid
Job Overview:
As a Case Manager, you will provide care coordination and support for enrollees in the DC Medicaid program, many of whom face behavioral health challenges and socio-economic barriers. Your role will involve conducting assessments, developing care plans, and ensuring that members receive the appropriate level of support based on their needs.
Additional Details:
Schedule: Monday-Friday, 8:00 AM - 5:00 PM, with flexible scheduling for field visits.
Location: 3400 Martin Luther King Jr. Ave SE, Washington, DC.
Salary: $75,000 - $80,000 + Children's National Benefits Package. (Some Flexibility with Salary)
Dress Code: Business casual.
Typical Day-to-Day Responsibilities:
Manage a caseload of Medicaid enrollees, assessing their needs and assigning an acuity level (1-3) to determine case management frequency and intensity.
Level 1: Well-managed cases requiring minimal Medicaid resources.
Level 2: Moderate resource utilization, requiring more frequent engagement.
Level 3: High-risk cases with greater healthcare needs, requiring frequent follow-up.
Conduct needs assessments to determine enrollees' health and social service needs.
Develop and maintain care plans to address medical, behavioral, and social challenges.
Work closely with enrollees, families, and healthcare providers to break down barriers to care.
Maintain a caseload of up to 100 enrollees, primarily ages 0-26, at Level 1 or Level 2 acuity.
Perform at least three field visits per week to engage with members, with two in-office days for documentation and collaboration.
Attend well-child visits when appropriate to provide additional support and update care plans.
Build relationships with primary care providers to enhance coordinated care efforts.
Training & Onboarding:
Three-week onboarding phase covering:
Company policies and procedures.
Medicaid contractual obligations and compliance.
Documentation and reporting requirements.
Hybrid work model: Initial training will require more in-office time, with regular in-person meetings on Tuesdays for support and guidance.
Qualifications:
Must-Have:
LGSW (Licensed Graduate Social Worker) certification.
At least two years of experience in case management, social work, or healthcare.
Background in pediatrics, health plans, or behavioral health.
Preferred:
Five years of experience in case management or healthcare.
Prior experience working with Medicaid members.
Health plan or managed care experience.
Soft Skills & Attributes:
Strong communication skills with the ability to connect with enrollees, families, and providers.
Empathetic and patient-centered approach.
Highly organized with the ability to manage multiple cases efficiently.
Passion for serving underserved populations and improving healthcare access
Interview Process:
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
