Disease Manager (LCSW)

Spectrum Healthcare Resources has a potential need for a Disease Managers (RNDM). Provides Disease Management services to TriCare beneficiaries. The Disease Manger collaborates with the clinical team to consult and collaboratively support the assessment, planning, implementation, coordination, monitoring and evaluation the beneficiary's health and psychosocial needs with a focus on empowering the beneficiary to successfully manage their medical, behavioral and psychosocial needs related to their chronic condition.

Requirements

Current, unrestricted SW licensure to independently work within scope of practice within state of residence (BSW)
• Minimum of two years experience in case management, care coordination or discharge planning in an acute, ambulatory or specialty disease management program settings in a healthcare system or managed care organization (MCO)

Preferred

• Care or Disease Management experience with a managed care organization (MCO)
• Master's degree in Social Work MSW; LCSW, LMSW
• Knowledge of government healthcare programs, TRICARE, and Medicare/Medicaid

Key Responsibilities

• Collaborate with the clinical to contribute to the whole-person plan of care by incorporating behavioral and psychosocial assessment findings utilizing evidence-based guidelines, clinical reasoning and clinical practice guidelines.
• Provide education and coaching support specific to the beneficiary's behavioral and psychosocial needs to prevent to support management of their chronic condition.
• Manage activities necessary to ensure appropriate utilization and access to medical and behavioral resources, while maintaining optimal standards of care.
• Review, identify and assist with identification and facilitation of resources related to health disparities identified through SDOH assessment.
• Participates in the development of measurable outcomes, ensures measure are in place to monitor the impact of programs and services on the health status of beneficiaries being managed.
• Assesses high risk factors, acuity and need for other TRICARE services and resources.
• Facilitate transfer of beneficiary between the different regions and within the regions by collaborating with the military liaison to support the transition with minimal disruption.
• Adhere to URAC standards, TRICARE policy, contractual requirements, and nationally recognized
• Assess beneficiaries to identify medical, physical, and psychosocial needs to support the beneficiary's overall goals of care.

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals.

Spectrum Healthcare Resources is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

EOE/AA/Disability/Vet