Licensed Master Social Worker
Licensed Master Social Worker
Pacer Staffing LLC
United States
See who Pacer Staffing LLC has hired for this role
Job Title: Licensed Master Social Worker
Duration: 6 months
Shift: Monday - Friday 8:00am – 5:00pm
Location - McAllen TX-will get training in the office for 1-2 weeks.
Duration: 6 months
Shift: Monday - Friday 8:00am – 5:00pm
Location - McAllen TX-will get training in the office for 1-2 weeks.
- Must have License master social worker**
- Must have degree in Social Worker**
- Review assessments & service plans (vendor or internal assessments)
- Follow up on pending assessment findings, clarify DX, reported abnormal, requested referrals, etc.
- Hospital discharges follow up.
- MN denials
- Research community resources.
- 2065D approval/denials
- Update LTSS
- Terminate LTSS waiver service authorizations.
- Provide community resources.
- Instruct members on appeal process and level change.
- ISP updates (internal), 1700-3 obtain verbal approval and update form, update 1700-2 with waiver items.
- Initiate LTSS/acute services (create authorization request template)
- Research complaints and provide updates to managers for complaint responses.
- Escalations
- MSC call backs.
- CDS review
- Acute UM denials to include PT denial, request for more information.
- Create clinical reviews/IRTs.
- CIC, CIS without MNLOC completion.
- Fair hearing assistance is needed.
- Determine MN for post assessment identified items.
- Dental, nursing, vision, verify service utilization, hearing, 90-day MHM, 28 day follow ups.
- Verify all services have been started.
- Follow up on all non DME identified needs.
- Send required referrals for new services/items identified except DME.
- Submit DME tasks for newly identified DME items.
- Review monthly audits and weekly calls to ensure we are meeting contractual requirements.
- Will call the employee to make sure they are signed in. They will complete new hire training.
- Service Coordinator
- Great collaboration amongst team
- Excellent computer skills
- Proficient in Word, Excel, and PowerPoint
- BS-Social Worker
-
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