About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
Brief Summary of Purpose:
The SCM provides services to members as referred by FH Care Management team or other referral sources. The SCM assesses member needs, services and resources to address social, health, or economic needs of FH members. The SCM assists the member and or family to provide care utilizing FH benefits and/or community resources. The SCM develops a plan to coordinate a continuum of care consistent with the members’ health care needs and/or goals. The SCM is able to utilize knowledge of benefit plan design, eligibility and/or financing alternatives available within the community to provide options that meet member’s needs.
The SCM is able to identify services, care delivery settings, and funding arrangements that meet the needs of the members. He/She recommends alternatives where appropriate. The SCM monitors care and provides consistent feedback to the team on progress. Works with community based groups to address service gaps and serves as a liaison to social and health resources. The SCM collaborates and works with the Inpatient/Outpatient Nurse Case Managers. The SCM is responsible for all activities related to:
In conjunction with both internal and external customers, the SCM promotes and works towards achieving the goals and objectives of the Case Management Department and Fallon Health.
Master’s degree from an accredited school of social work, mental health counseling, psychology, or human services required.
Licensed or licensed eligible if applicable. Certification in Case Management desired.