MEDICAL SOCIAL CARE SPECIALIST 2 MEDICAL ASSISTANCE AND HEALTH SERVICES

Definition

Under direction of a supervisory official in a state department, performs varied tasks related to the social assessment and planning for Medicaid eligible persons requesting either placement/transfer into long term care facilities, or alternative community programs requiring social work activity; acts as case manager in the development of health care, plans in arranging services for certain Medicaid clients; does other related duties.

Examples of work

• Maximizes the use of community resources according to client needs; makes recommendations to ensure provision of the most cost effective and qualitative services based on client requirements; collects, analyzes, and records significant data, drawing sound conclusions to base appropriate action thereon.
• Interviews the client, family, relatives, neighbors, and others to assess need for and arrange services; explains Medicaid procedures, obtains social data in accord with established criteria.
• Resolves social problems related to client's health by visiting clients and families to assist in the planning and implementation of care programs.
• Initiates the analysis, evaluation, planning, goal setting, and decision making in individual case situations with respect to cost effectiveness; assessment is based on a particular program, long term care placements, medical/social day care, and home health care.
• Organizes care plans for client; provides counseling in anticipating and solving problems of personal, emotional, economical, cultural, and environmental factors; works with and advises individuals, families, and others. Complies with federal and state criteria.
• Develops and maintains liaison with appropriate agencies, for example, office on aging, county welfare agency, long term care facilities, psychiatric and acute care hospitals; maintains client confidentiality.
• Identifies gaps in services and notifies appropriate personnel and/or agency; makes full use of community resources on behalf of clients.
• Deals with the clients and their families to implement goals using agency and community resources.
• Establishes and maintains records and files.
• Develops and evaluates the social data in the (MET) medical evaluation team conference; conferences with providers, contributes social data;,recommends and approves level of care and services pertinent to client's welfare.
• Plans and conducts support groups for families in transition, groups are designed to encourage participation with a view towards development of improved attitudes, cooperative relationships, social re-education, and adjustment.
• Prepares and organizes presentations on Medicaid for community agencies.
• Investigates, analyzes, and reports abuse and neglect situations as required by law, refers cases to appropriate agencies, handles complex placements, and is at times exposed to high risk situations.
• Evaluates potential denial of Medicaid services to community applicants and/or patients in long term care facilities.
• Prepares reports, plans, information, and goals and provides testimony to hearing officers where hearings have been requested.
• Participates in special projects and/or pilot programs for the purpose of evaluation and implementation.
• Maintains standardized current community resource directory, including the social services network.
• Maintains a directory of long term care facilities within the geographical confines of the Medicaid District Office.
• Interprets social service policies and procedures to providers, institutions, agencies, recipients, and other concerned individuals.
• Participates in staff meetings to present suggestions and share information and professional materials.
• Prepares statistical reports containing findings, conclusions, and recommendations which reflect worker and case activity.
• Maintains records and files.
• Drafts correspondence.
• Assists in development and revision of social service assessment forms.
• Makes special investigations.
• Will be required to learn to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.

Education

Graduation from an accredited college or university with a Bachelor's degree in social work or related field.

Experience

Two (2) years of experience in social work, one(1) of which shall have been in a field of gerontology, health care, mental health/developmentally disabled, or a combination thereof.

License

Appointee will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.

Knowledge, skills and abilities

• Knowledge of the economic, social, emotional, and other problems affecting the elderly and disabled population.
• Knowledge of the problems involved in dealing constructively with human relationships, personality disorders, social behavior, and social relationships.
• Knowledge of the organization, functions, relationships, and programs and practices of state and local health and welfare organizations and services.
• Knowledge of Medicare, Medicaid, PAAD, SSI, and other financial assistance programs.
• Knowledge of the philosophy of interacting techniques and the program design and procedures used in social service delivery programs.
• Knowledge of long term care facilities and services in the state.
• Knowledge of procedures applied to the transfer and relocation of clients.
• Ability to read and understand information on counseling techniques and crisis intervention skills.
• Ability to read and interpret legislation relating to human service and protective service programs.
• Ability to assist clients and families in reviewing options for care.
• Ability to make appropriate referrals.
• Ability to organize assigned field and office work, analyze problems, and develop appropriate work methods.
• Ability to collect and evaluate information concerning the social relationships of individuals and families.
• Ability to coordinate agency services and care to implement care plans for clients.
• Ability to make field visits, studies, and investigations, and prepare detailed case histories, records, and reports.
• Ability to interview persons with emotional problems and obtain pertinent information to plan realistic goals for improved family and/or individual functioning.
• Ability to function as an effective member of a health care team.
• Ability to apply the laws, rules, and regulations of New Jersey and the department pertaining to the welfare of clients and their families.
• Ability to collect social data, assess social problems, and develop an appropriate social care plan for clients and families.
• Ability to act as a representative of the Division, to make presentations, and to attend and participate in hearings, meetings, and conferences.
• Ability to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.
• Ability to read, write, speak, understand, and communicate in English sufficiently to perform duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication.
• Persons with mental or physical disabilities are eligible as long as they can perform essential functions of the job after reasonable accommodation is made to their known limitations. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.
• CODES: P19- CAH 5/5/99

Note

The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed.

A supervised and accredited field placement of three hundred (300) hours performed in a social agency, or a Master's degree in psychology, guidance and counseling, divinity, social work, or other related behavioral science maybe substituted for one (1) year of experience.