Responsible for evaluating and managing the psychosocial aspects of identified cases within the clinical program.
Supports the clinical management analyst in managing complex cases. Optimizes resources to the community
available to the policyholder. Provides intensive social work support in identified cases of members who meet
enrollment criteria, focusing on members who are complex, high, moderate and low risk. Develop treatment plans,
that’s includes a variety of support to members with serious or severe physical illnesses, developmental disabilities,
caregiver burnout or complex psychosocial barriers that interfere with obtaining maximum benefits from qualifying
· Evaluates the psychosocial aspects of cases referred and discusses the findings with the clinical
management analyst (findings include, but are not limited to, social character, psychological,
environmental, and essential information for the case management).
· Realize on site visits for social needs evaluation.
· Coordinate mental health services.
· Liaison between primary medical groups and care management unit.
· Develops an individualized work plan, based on identified social problems and needs.
· Provides support and consultation to the patient, so that he/she can adjust adequately to temporary and
permanent changes caused by illness and treatment.
· Identifies resources for the community, serves as liaison, and refers cases, as necessary.
· Support with cases in the process of application and acquirement of services offered by agencies and
· Collaborates in the fulfillment of recommendations established in the care plan.
· Identifies and maintains relations with community resources and agencies committed to offering services
and care to vulnerable populations.
· Document interventions in the care management tool and follow up members until their interventions
· Comply with established daily, weekly and monthly outreach goals.
· Other tasks as assigned by management and that are essential.
· Current/ valid license Puerto Rico Social Worker, in Good standing or without restrictions.
· Member of College of Social Workers of Puerto Rico.