POSITION SUMMARY:

The Medical Social Worker provides clinical social work services to patients and their families, which will primarily consist of working to reinstate Medicaid coverage for active patients who have lost their insurance. This may include traditional Medicaid as well as Medicaid managed care plans (i.e., ACOs, MCOs, ICOs, SCOs, etc.). The MSW will reach out to patients, case workers, rep-payees, patients’ families, and Medicaid directly to facilitate reinstatement, as well as work with our clinical team to help transition patients off services if they no longer qualify for Medicaid coverage. The MSW will be expected to be part of a team that assists in care coordination to ensure that medically appropriate home health care services are resumed for patients who have been transferred to other points of care. The successful incumbent will utilize their professional experience to identify and address social and environmental barriers to care for the underserved population.

What you'll do:

• Obtains initial documentation needed to speak to Medicaid on behalf of the patient.
• Responsible for daily correspondence with the clinical team to obtain all required documentation from the patient, the patient’s family, or their rep-payee during the period of loss.
• Updates internal systems to track progress towards reinstatement.
• Works closely with the Finance team to identify high-risk patients.
• Identifies coverage loss patients who no longer qualify for Medicaid.
• Communicates any issues preventing reinstatement to the Sr. Manager of Clinical Documentation and the Sr. Director of Financial Strategy. 
• Collaborates with the clinical team to transition or safely discharge a patient when appropriate.
• Works closely with clinical team to identify and remedy scenarios where social determinants of health are negatively impacting disease process.
• Effectively communicates with referral sources external to Innovive to ensure a seamless transfer of patient care from Innovive to other points of care, and successful coordination back to Innovive.
• Ensures that relevant documentation to support MSW activities are completed in EMR, Salesforce, and any other necessary platforms.
• Performs other duties as assigned.

• Master’s degree in social work 
• Working knowledge of Clinical policies and procedures
• Licensed Independent Clinical Social Worker (LICSW) in the State of Massachusetts (with the expectation of obtaining licensure in additional states due to geographic expansion)
• Healthcare experience
• Knowledge and respect of all confidentiality issues
• Ability to work effectively with people of diverse cultures, ages, and economic backgrounds in a culturally competent and sensitive manner

• Competitive salary based on experience
• Flexible Schedules to fit your lifestyle
• Comprehensive benefits package includes medical, dental, vision, disability, and life insurance
• 24 days of paid time off
• Paid Company Holidays
• 401k with company match
• Dayforce Wallet - voluntary benefit that gives you access to earned pay
• Wellness program
• Mileage reimbursement
• Tuition reimbursement
• Company-issued iPad with electronic health record system
• Online CEU credits through MedBridge
• Rewarding one-on-one care
• One-on-one mentoring and 24/7 clinical support
• Excellent career growth opportunities

Innovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.