Social Worker (MA/MSW)

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary: Under the supervision of the Transition of Care Clinical Program Manager, the Social Worker is responsible for collaborating with member of the interdisciplinary care team to facilitate member's successful transition from acute or post-acute care setting to home and is accountable for utilizing the social work general practice model to affect transition to home outcomes for Prominence Health members. He/she is responsible for engaging with members in the outpatient setting in need of resources to avoid poor health outcomes, frequent emergency room visits, and hospital readmissions.

The Social Worker receives referrals or identifies hospitalized high-risk, complex members in need of social services and communicates with all entities involved in the care of the member to promote and maximize care coordination. Key aspects of the TOC Program protocols are based upon inpatient and post-discharge workflows. Inpatient workflow includes conducting assessments, member and family education regarding available resources, identification of member-level concerns regarding discharge, and anticipation of potential gaps in care. The inpatient encounters are designed to educate members/caregivers surrounding their post discharge needs and to empower them to play an active and informed role in managing their care post-discharge.

Additionally, the Social Worker may organize support groups or counsel family members to assist them in understanding, dealing with, and supporting the member either during the inpatient stay or post discharge. To support continued development the Social Worker may plan and conduct programs well as develop or advise on social policy to combat social problems, and impact community health issues.

The Social Worker will adhere to the Social Worker Scope and Standards of Professional Practice in the state in which the member she is conducting care with resides. Additionally, the position includes participation in efforts associated with the successful implementation and operation of the SNP CM program and that the model of care (MOC) meets or exceeds regulatory and accreditation requirements for the Centers for Medicare and Medicaid Services (CMS), state Medicaid offices (as relevant), and NCQA.

Benefit Highlights:

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! * More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications and Requirements:

• Master's Degree in Social Work, required
• At least 1 year of Experience in the Medical Social Work field, preferably transitional or case management social work. Candidate must have knowledge of social and physical factors that affect functional status at discharge, and knowledge of community resources to meet post discharge clinical and social needs.
• Minimum active, Licensed Clinical Social Worker in the state of Nevada, Texas, and/or Florida
• Ability to obtain licensure in various states.
• Preferred: CCM, C-SWCM, or CMCP
• Ability to effectively communicate in English (Nevada, Texas, and Florida markets), Spanish (Texas and Florida markets) and/or Tagalog (Florida market), both verbally and in writing depending on the State of Clinical Social Worker licensure and employment location.
• Experience working with the Medicare and Medicaid population segment, required
• Knowledge of Medicare/ Medicaid processes and compliance standards, preferred.
• Proficiency in gathering and interpreting empirical evidence, formulating recommendations, action plans and interventions to improve the overall organization strategy.
• Simultaneous action at varying stages-initiation, follow through, and completion-on a number of different projects.
• Demonstrated ability to research, analyze and interpret state/federal regulations related to health insurance and healthcare.
• Demonstrated ability to communicate verbally and with technical writing in a way that effectively conveys project background, objectives, activities, evaluations, conclusions, and recommendations.
• Demonstrated skills in critical thinking, problem solving, and the analysis, interpretation, and evaluation of complex information.
• Demonstrated ability to work independently with minimal supervision.
• Demonstrated ability to maintain effective collaborative working relationships with staff.
• Resourceful, detail-oriented, and able to assimilate and analyze a wide variety of information, often working under deadline pressure with a variety of levels of staff.
• Strong project management skills.
• Computer Skills: Smartsheet, SharePoint, Microsoft Office (Word, Excel, PowerPoint), and database software.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS

and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.