Social Work Care Manager - MSW

Posted Date 2 months ago(10/2/2023 10:34 AM)
Requisition ID
# of Openings
Area of Interest
Social Work
Monroe County
Position Type
Regular Full-Time
$25.20 - $36.75 / Hour


$25.20 - $36.75 / Hour


Elderwood Health Plan is looking for a Masters prepared Social Work Care Manager to join our growing team! This position is located in Monroe County. MSW Required. 


Social Work Care Manager (MSW) - Position Overview:

  • The Social Work Care Manager will provide individualized support and advisement to clients and families seeking to apply for Medicaid funded Long Term Care Services.
  • Primary responsibilities will include assessment and interventions related to obtaining and retaining long term care and in supporting a member centric service plan.
  • This process is key to assisting our clients maintain the highest level of independence possible both at home and within their communities.
  • The Social Worker partners with the RN Care Manager to facilitate the care model in MLTC by coordinating services and community resources and meeting member socioeconomic needs to support the quality of life.

Join Our Team

Are you looking to take the next step in your career?


Social Work Care Manager (MSW):

  • Direct telephonic and in-person engagement with individuals with chronic medical illness or mental health issues and their families.
  • Utilize assessment tools to determine the needs of our member population
  • Link members to resources in the community outside of the scope of services MLTC provides to support social determinants of health.
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address/support medical needs. 
  • Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
  • Assists with problem solving when care barriers are identified.
  • Documents in the EMR each encounter or routine contact with members, providers or caregivers and reports changes in conditions to the RN Care Manager, which may require interventions.
  • Promote empowerment of members in self-management of disease and provides individual support to members and their families as needed.
  • Participate in Interdisciplinary Team meetings, Disease Management, Utilization Management, and Quality Improvement activities and prepare/submit activity reports.
  • Work with all departments of Elderwood Health Plan to ensure members are receiving appropriate services
  • Determine member and family needs to develop a comprehensive care plan and referral to community resources for each member based on counseling, housing, social support, legal issues, crisis intervention, emotional need and financial status.
  • Provide coaching and education to members and their caregivers on health care related issues such as advanced directives, disease, chronic condition, and medication management. Initiate patient education based on identified learning needs of the member and/or those providing care.
  • Assisting with completion of advance directives as needed
  • Early identification of incipient problems or significant changes in member conditions
  • Working with Local Department of Social Services to assist in coordinating member services
  • Provide discharge planning and continuous care management across care settings (i.e., home, hospital and/or nursing homes) and coordinate the transition planning (i.e., discharge from a hospital or nursing home) to ensure that the member receives the appropriate array of services upon discharge or return to home.
  • Participate in shared on-call, after-hours coverage along with other Health Plan staff.
  • Perform other related duties and responsibilities as directed within the scope of services Elderwood Health Plan provides including in person meetings with members in the community.


USD $25.20/Hr.

Up to

USD $36.75/Hr.


Social Work Care Manager (MSW):


Education: MSW

Required Experience:

  • Minimum of one (1) year Social Work experience with at risk populations in home care, case management, discharge planning or managed care.
  • Minimum of one (1) year experience working with a frail or elderly population and/or members with chronic illness or behavioral health issues.
  • Previous Managed Care experience, within a MLTC or working with special needs populations preferred.

Additional Requirements:

  • Must have a valid NYS Driver’s license, a safe driving record and dependable car
  • Must travel throughout service area to meet with members in the community
  • Must be in good standing with the Medicare and Medicaid programs.
  • Must be free of communicable disease.
  • Bilingual skills are preferred, but not required.


  • Knowledge of the community resources for the frail, elderly and disabled.
  • Advanced ability to communicate on any level required to meet the demands of the position.
  • Ability to assess member needs, create, review and interpret service plans.
  • A strong health care knowledge base including Medicaid eligibility guidelines, knowledge of pooled income trusts and Medicaid home care.
  • Knowledge of the principles and skills needed to provide patient-centered care management.
  • Must possess proficient computer skills, including working knowledge of Microsoft Office Suite, e-mail systems, electronic medical records, and web-based programs.
  • HIPAA Privacy

EOE Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.


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