Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.
The Social Worker, as part of a multidisciplinary team, including the patient/family, physicians, nurse’s therapists, and payors ensures the patient’s progress in the acute episode of care through post discharge and is quality driven while being efficient and cost effective. The incumbent interacts with patients, family members, healthcare professionals, and community and state agencies in this effort.
The Care Manager/Social Worker serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information. The Care Manager/Social Worker reviews high risk patients from a psychosocial and medical perspective and assesses the psychological needs of patients and families and provides information, support, counseling, care management, and referrals to appropriate resources.
The SW Care Manager and RN Care Manager work collaboratively to ensure patient needs are met and care delivery is coordinated across the continuum. The expertise of the SW is sought to resolve psychosocial patient care issues and to develop complex patient transition/discharge plan as needed.
The Care Manager/Social Worker is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series provides case review to third party payers and assisting in the denial and appeals process as well as assessing quality, levels of care and identifying and reporting potential risk management issues. The incumbent performs duties and tasks in accordance with performance standards established for the job. The incumbent may have access to highly confidential patient, employee and/or proprietary information, and must handle & protect the information in accordance with hospital & system policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization.
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.
Our office is located at Sebasticook Valley Hospital (SVH) 447 N Main St, Pittsfield, ME 04967. Employees will be required to work some days onsite and some days from home.
We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.
If you are located in Pittsfield, ME, you will have the flexibility to work from home and in the office in this hybrid role* as you take on some tough challenges.
Primary Responsibilities:
Medical Record Review:
Reporting:
Computer Skills:
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Preferred Qualifications:
Soft Skills:
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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