CrawlJobs Logo

Social Work Consultant II

kaiserpermanente.org Logo

Kaiser Permanente

Location Icon

Location:
United States , Duluth

Category Icon

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

37.25 - 48.17 USD / Hour

Job Description:

Mental health is an essential component of total health. As mental health professionals, we’re on the front lines every day, using the latest advances to help those in need. If you share our passion for care and our commitment to helping those around us, you’ll have the resources you need to make a real difference. Our services include adult and child therapy as well as help with addiction and eating disorders. Job Summary: Discharge Planning: The primary role of the Medical Social Worker II for hospital settings is to facilitate the execution of approved and appropriate inpatient discharge plans between facilities or into the community. Under general direction of the Continumm of Care Leader and via clear and consistent communication with the onsite care management staff, delivers age-appropriate clinical social work insight and care to members and their caregivers in accordance with agency policy and procedure and state and federal regulations. The Medical Social Worker II serves as an integral member of the healthcare team ensuring coordination of discharge/transition planning and providing referrals to internal resources within the Kaiser Permanente network, information to community resources and other social work services to meet the complex needs of patients and families transitioning from hospital settings.

Job Responsibility:

  • Discharge Planning: The primary role of the Medical Social Worker II for hospital settings is to facilitate the execution of approved and appropriate inpatient discharge plans between facilities or into the community
  • Responsible for overseeing or participating in individual discharge plans which assist members and families to transition to the appropriate level of care
  • Partners with multidisciplinary teams to identify needs and collaborate and execute individual discharge plans
  • Discuss options for care proactively including Kaiser resources and external community/government resources to assist member and caregiver(s) in developing short- and long-term care plans as appropriate
  • Collaborates with other disciplines in assessing, planning, and providing services for patients utilizing biopsychosocial information
  • Coaches member pre-discharge in advocating for self to receive appropriate services within Kaiser and in the community
  • Ensures member and caregiver(s) are updated with approved discharge plans
  • Takes, reviews, evaluates, and prioritizes written and oral referrals
  • Maintains documentation, records, and data collections
  • Responsible for completion of required documents in a complete and timely manner
  • Functions as liaison to the Post-Acute Team to assure appropriate, timely placement of Kaiser members in facilities
  • Serves as a liaison between patient and Kaiser maintaining positive relationship with Kaiser and providing for continuity of care
  • Identifies appropriate levels of care and facilities for referred patients, were applicable
  • Obtains placements, where applicable
  • Collaborates with internal and external resources in Kaiser and the community to meet mutually agreed upon goals and objectives
  • Provides information and referral to community resources as requested
  • Coordinates exchange of information among Kaiser, families, members, and all facilities involved in the discharge plan
  • Determines application of Kaiser, Medicare, and any additional insurer benefits to specific patient situations
  • Coordinates the application of all active insurance coverage for the purposes of care transitions and ensures that coverage benefit coordination is communicated to all facilities involved
  • Participates in Utilization Management/Quality Assurance activities
  • Assists in coordinating communication between regional offices, clinics, hospitals, and field staff
  • Remains knowledgeable of contract benefits and current, relevant state and Federal regulations, criteria, documentation requirements and laws that affect managed care and case/utilization management
  • Works cross-functionally with other departments in striving to meet organizational goals and objectives
  • Works with referral sources to clarify and complete required clinical and psychosocial information
  • Provides consulting services to the local Kaiser Permanente Acute Care Centers, Clinical Decision Units, and core hospital KP partners on occasion
  • Escalates issues and barriers timely and appropriately
  • Perform other related duties as necessary

Requirements:

  • Minimum two (2) years social work experience identifying and managing discharge and psychosocial needs of inpatients in an acute care or managed care setting within the last five (5) years
  • Masters degree in social work conferred by a program accredited by the Council of Social Work Education
  • Licensed Master Social Worker (Georgia) OR Associate Marriage and Family Therapist License (Georgia) OR Associate Professional Counselor License (Georgia) OR Licensed Clinical Social Worker (Georgia)
  • Demonstrated ability to perform on a multidisciplinary team
  • Must have strong psychosocial assessment skills
  • Knowledge of chronic and acute disease and how it impacts patient and family functioning
  • Demonstrated excellent oral/telephone communication skills and written documentation
  • Must be experienced in documenting in an electronic clinical information system
  • Must demonstrate ability to effectively and efficiently handle demanding workload involving multiple tasks
  • Demonstrated ability to function independently as a collaborative, supportive team member
  • Must be able to synthesize detailed and complex information regarding benefits and coordination of care
  • Must be able to assess SDOH needs and determine appropriate resources for addressing them
  • Proficiency with using multiple computer systems for research and documentation
  • Knowledge of community resources in Georgia required

Nice to have:

  • CCM certification preferred
  • Keyboarding skills at least 60wpm preferred
What we offer:
  • Medical, Vision & Dental
  • Professional Development
  • Retirement Plans
  • Vacation, Holiday & Sick Leave
  • Supportive Teams & Resources

Additional Information:

Job Posted:
January 06, 2026

Work Type:
On-site work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Social Work Consultant II

Social Work Consultant

Mental health is an essential component of total health. As mental health profes...
Location
Location
United States , Atlanta
Salary
Salary:
37.25 - 48.17 USD / Hour
kaiserpermanente.org Logo
Kaiser Permanente
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum two (2) years social work experience identifying and managing discharge and psychosocial needs of inpatients in an acute care or managed care setting within the last five (5) years
  • Masters degree in social work conferred by a program accredited by the Council of Social Work Education
  • Licensed Master Social Worker (Georgia) required at hire OR Associate Marriage and Family Therapist License (Georgia) required at hire OR Associate Professional Counselor License (Georgia) required at hire OR Licensed Clinical Social Worker (Georgia) required at hire
  • Demonstrated ability to perform on a multidisciplinary team
  • Must have strong psychosocial assessment skills
  • Knowledge of chronic and acute disease and how it impacts patient and family functioning
  • Demonstrated excellent oral/telephone communication skills and written documentation
  • Must be experienced in documenting in an electronic clinical information system
  • Must demonstrate ability to effectively and efficiently handle demanding workload involving multiple tasks
  • Demonstrated ability to function independently as a collaborative, supportive team member
Job Responsibility
Job Responsibility
  • Discharge Planning: The primary role of the Medical Social Worker II for hospital settings is to facilitate the execution of approved and appropriate inpatient discharge plans between facilities or into the community
  • Under general direction of the Continumm of Care Leader and via clear and consistent communication with the onsite care management staff, delivers age-appropriate clinical social work insight and care to members and their caregivers in accordance with agency policy and procedure and state and federal regulations
  • The Medical Social Worker II serves as an integral member of the healthcare team ensuring coordination of discharge/transition planning and providing referrals to internal resources within the Kaiser Permanente network, information to community resources and other social work services to meet the complex needs of patients and families transitioning from hospital settings
  • Responsible for overseeing or participating in individual discharge plans which assist members and families to transition to the appropriate level of care upon the completion of the acute Treatment Plan with the measure of restoring social, emotional, financial, and environmental factors which affect and/or affected by the acute inpatient stay
  • Partners with multidisciplinary teams to identify needs and collaborate and execute individual discharge plans
  • Discuss options for care proactively including Kaiser resources and external community/government resources to assist member and caregiver(s) in developing short- and long-term care plans as appropriate
  • Collaborates with other disciplines in assessing, planning, and providing services for patients utilizing biopsychosocial information
  • Coaches member pre-discharge in advocating for self to receive appropriate services within Kaiser and in the community
  • Ensures member and caregiver(s) are updated with approved discharge plans
  • Takes, reviews, evaluates, and prioritizes written and oral referrals
What we offer
What we offer
  • Medical, Vision & Dental
  • Professional Development
  • Retirement Plans
  • Vacation, Holiday & Sick Leave
  • Supportive Teams & Resources
  • Parttime
Read More
Arrow Right

Care Management Specialist II

The Care Management Specialist II utilizes clinical skills and training to perfo...
Location
Location
United States , Los Angeles
Salary
Salary:
88854.00 - 142166.00 USD / Year
lacare.org Logo
L.A. Care Health Plan
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Associate's Degree in Nursing for Registered Nurses OR Master's Degree in Social Work for Licensed Clinical Social Workers
  • Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
  • Experience providing care management with complex/catastrophic conditions
  • Current knowledge of clinical standards of care and disease processes
  • Critical thinking skill
  • Excellent customer service skills
  • Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
  • Ability to triage immediate member health and safety risks
  • Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping
  • Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders
Job Responsibility
Job Responsibility
  • Utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines
  • Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases
  • Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner
  • Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit
  • Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team
  • Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
  • Uses claims processing and care management software to look up member information, document contacts, and track member progress
  • Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary
  • Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
  • reviewing member claims histories and identifies intervention opportunities through the professional standards of practice
What we offer
What we offer
  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)
  • Fulltime
Read More
Arrow Right

Care Management Specialist II, D-SNP Team

The Care Management Specialist II utilizes clinical skills and training to perfo...
Location
Location
United States , Los Angeles
Salary
Salary:
88854.00 - 142166.00 USD / Year
lacare.org Logo
L.A. Care Health Plan
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Associate's Degree in Nursing for Registered Nurses OR Master's Degree in Social Work for Licensed Clinical Social Workers
  • Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
  • Experience providing care management with complex/catastrophic conditions
  • Current knowledge of clinical standards of care and disease processes
  • Critical thinking skill
  • Excellent customer service skills
  • Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
  • Ability to triage immediate member health and safety risks
  • Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping
  • Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders
Job Responsibility
Job Responsibility
  • Utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines
  • Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases
  • Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner
  • Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit
  • Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team
  • Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
  • Uses claims processing and care management software to look up member information, document contacts, and track member progress
  • Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
  • Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
  • reviewing member claims histories and identifies intervention opportunities through the professional standards of practice
What we offer
What we offer
  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)
  • Fulltime
Read More
Arrow Right

Full-time Lecturer at the Faculty of Computer Science and Informatics

The Full-time Lecturer at the Faculty of Computer Science and Informatics is res...
Location
Location
Germany , Berlin
Salary
Salary:
55000.00 EUR / Year
gusgermany.com Logo
GUS Germany GmbH
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • PhD with strong theoretical and practical knowledge in at least one of the following areas: (i) Data Analytics and Visualisation, (ii) Big Data Analytics, (iii) Machine Learning, (iv) Deep Learning, (v) Computer Vision, (vi) Chatbot Systems, (vii) Robotics and Automation Systems
  • Prior teaching experience in higher education at the University level
  • Strong working knowledge of Python Programming
  • Very good knowledge of Windows OS, of MS Office suite (Excel, Word, Outlook, PowerPoint) and Microsoft Teams
  • Scientific publications in a related discipline
  • Fluent in spoken and written English (C2 level)
  • Knowledge of Educational Platforms (i.e., Canvas, Blackboard etc.)
  • Sound knowledge of study regulations and rules
  • Very good organisational and communication skills
  • High social competence and assertiveness
Job Responsibility
Job Responsibility
  • Teaching academic modules in Data Analytics, Machine Learning, and related AI domains
  • Designing and updating curricula
  • Creating and grading assignments and exams
  • Participating in school activities as directed by the Dean of the Faculty and Chief Academic Officer
  • Mentoring students
  • Providing individualised tutoring to enhance academic performance
  • Monitoring progress
  • Developing creative teaching materials to support learning in AI and data analytics
  • Administering, proctoring and marking all students’ assignments and exams papers of all assigned classes
  • Updating a Syllabus or Syllabi if required
What we offer
What we offer
  • An international environment with a multicultural audience and a meaningful social impact
  • Support in achieving your professional goals and development
  • Opportunities for career growth alongside BSBI, including leadership roles
  • Extensive training to equip you with the knowledge and skills needed to excel
  • Work in a young, dynamic and positive culture that fosters collaboration
  • Performance-based commissions to incentivise sales success
  • Be at the forefront of an exciting educational opportunity, leading the way forward and growing with BSBI
  • Fulltime
Read More
Arrow Right

Medical Appeals/Grievance Specialist II - Registered Nurse

Responsible for utilizing clinical acumen and managed care expertise related to ...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 1 year experience in clinical and health insurance or other healthcare related field
  • 3 years experience in clinical and health insurance or other healthcare related field AND 1 year Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
  • 5 years experience in clinical and health insurance or other healthcare related field AND 2 years Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
  • 8 years experience in clinical and health insurance or other healthcare related field AND 3 years above satisfactory job performance in the managed care environment with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
  • Associate’s Degree in a healthcare field of study or Nursing Diploma
  • Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) or a compact state as a Registered Nurse (RN), a Physical Therapist (PT) or a Licensed Master Social Worker LMSW.
  • Intermediate PC proficiency
  • Intermediate skill using office equipment, including copiers, fax machines, scanner and telephones
  • Maintain confidentiality and privacy
  • Advanced clinical knowledge
Job Responsibility
Job Responsibility
  • Perform in-depth analysis, clinical review and resolution of provider appeals/inquiries, corrected claims and subscriber reconsiderations, member appeals, corrected claims and provider grievances for all lines of business
  • Identify, research, process, resolve and respond to customer inquiries primarily through written / verbal communication.
  • Respond to a diverse and high volume of health insurance appeal related correspondence on a daily basis.
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of appeal, grievance and reconsideration requests.
  • Maintain complete and accurate records per department policy.
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
  • Demonstrate ability to apply plan policies and procedures effectively.
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
  • Attend staff and interdepartmental meetings.
  • Participate in continuing education and current developments in the fields of medicine and managed care.
  • Fulltime
Read More
Arrow Right
New

Honda Certified Technician

Boardwalk Honda is part of the fast growing Group 1 Automotive, a leader in auto...
Location
Location
United States , Egg Harbor Township
Salary
Salary:
15.14 - 57.69 USD / Hour
Group 1 Automotive
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Honda certification
  • A Positive & Friendly Attitude
  • Tools based on your experience
  • Communication Skills
  • Basic Computer Skills
  • Strong Desire to Provide an Exceptional Client Experience
  • Ability to Achieve Targeted Goals
  • High School Diploma or Equivalent
  • Must have a Valid Driver’s License
What we offer
What we offer
  • $5,000 Sign on Bonus (terms & limits apply)
  • Market Leading Pay, based on experience, Plus Bonuses
  • A Great Working Environment with the Latest Equipment
  • Structured, Self-paced and paid Training Opportunities Leading to Manufacturer and Group 1 Recognition
  • Pinnacle Awards Program
  • Health, Dental & Vision Insurance
  • Life & Disability Insurance
  • 401(k) with Company Match
  • Paid Time off
  • Employee Vehicle Purchase Program
  • Fulltime
Read More
Arrow Right
New

Used Car Technician/mechanic

Ira BMW of Stratham is looking for Quality, Used Car Service Technicians/Mechani...
Location
Location
United States , Stratham
Salary
Salary:
Not provided
Group 1 Automotive
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Automotive Technician/Mechanic Experience
  • A Love of Everything Automotive
  • A Positive & Friendly Attitude
  • Tools based on your experience
  • Communication Skills
  • Basic Computer Skills
  • Strong Desire to Provide an Exceptional Client Experience
  • Ability to Achieve Targeted Goals
  • High School Diploma or Equivalent
  • Must have a Valid Driver’s License
What we offer
What we offer
  • A True Four Day Work Schedule
  • Market Leading Pay, based on experience, Plus Bonuses
  • A Great Working Environment with the Latest Equipment
  • Structured, Self-paced and paid Training Opportunities Leading to Manufacturer and Group 1 Recognition
  • Health, Dental & Vision Insurance
  • Life & Disability Insurance
  • 401(k) with Company Match
  • Paid Time off
  • Employee Vehicle Purchase Program
  • Employee Stock Purchase Plan
  • Fulltime
Read More
Arrow Right
New

Entry Level Automotive Technician/Mechanic

Kickstart Your Automotive Career with a Winning Team! Join Ira Toyota of Manches...
Location
Location
United States , Manchester
Salary
Salary:
18.00 USD / Hour
Group 1 Automotive
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • A positive, team-oriented attitude
  • Desire to grow and build a successful career in automotive service
  • Basic computer and communication skills
  • Commitment to delivering excellent customer service
  • Valid driver’s license and clean driving record
  • High school diploma or equivalent preferred
  • Must pass pre-employment screenings including background check, MVR, and drug test
What we offer
What we offer
  • Flexible schedules – 3, 4, or 5-day work options
  • Toyota Technician Mentoring Program
  • Toyota Certification and ongoing paid training
  • Weekly employee appreciation lunches
  • Paid Time Off (PTO)
  • Medical, Dental, Vision, Life & Disability Insurance
  • 401(k) plan with company match
  • Employee Stock Purchase Plan
  • Employee Vehicle Purchase Program
  • Professional work environment with advancement opportunities
  • Fulltime
Read More
Arrow Right