The Licensed Clinical Social Worker (LCSW) provides advanced clinical social work services to members with complex medical, behavioral health, substance use, and psychosocial needs. The position conducts comprehensive psychosocial and behavioral health assessments, develops individualized interventions and care plans, provides crisis intervention, and supports complex case management, care coordination, and transitions of care. The LCSW collaborates with members, families, providers, hospitals, the health plan's behavioral health delegate, and interdisciplinary teams to address barriers to care and improve health outcomes.
The LCSW serves as a clinical subject matter expert in behavioral health and substance use disorders and provides advanced clinical consultation and support for complex cases. The position supports Complex Case Management, Population Health Management (PHM) initiatives, transitions of care, and behavioral health quality initiatives, including interventions to address applicable behavioral health HEDIS care gaps. The position works collaboratively with Case Management, Quality, and other interdisciplinary teams to support health plan quality initiatives.
The position also supports health plan quality and regulatory initiatives, including NCQA accreditation, HEDIS improvement, health equity, DMHC/HEQMS requirements, population health program implementation, and quality performance improvement