Fallon Health

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Social Work Manager-55+ all Inclusive Program - no nights no weekends

Location US-MA-Leominster
Posted Date 2 weeks ago(5/15/2025 1:54 PM)
Job ID
7940
# Positions
1
Category
Social Work

Overview

About us:

Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality.

 

Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. 

 

Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. 

 

Summary of purpose: 

Functions as a member of the PACE Interdisciplinary Team and provides social work services, support and counseling to participants, families and other caregivers. Supervises and directs the Social Work Department inaccordance with accepted social work practice. Collaborates with IDT and SE management team to ensure utilization and MLR targets are met.

Responsibilities

Primary Job Responsibilities

 
• Participates in Interdisciplinary Team’s initial assessments, care planning and on-going re-evaluations.
   Primary job responsibilities:
• Provides clinical services to participants and families in the form of psychosocial assessment and treatment.
• Provides on-going case management for participants as needs and status changes.
• Identifies and coordinates resources for participants and their families. Refers participants and their families to appropriate community/government agencies.  Acts as advocate and liaison to obtain needed services.
• Participates in care planning, family meetings, enrollment/disenrollment, and reassessments of SE participants to meet regulatory requirements.
• Assures that participants rights are reviewed during the intake process.
• Participates in meetings, committees, in-services, orientation etc. as required. 
• Participates in policy/procedure and job description development for Social Work Department.
• Establishes and maintains effective collegial relationships with interdisciplinary team members.
• Develops collaborative relationships with other health and human services agencies and community providers.
• Consults with and advises staff members of the relationship of social, emotional, and cultural factors of health and medical care.
• Participates in Quality Improvement initiatives.  Encourages and facilitates subordinates’ ability to participate.
• Directly supervises and provides clinical supervision to other social workers.  Interviews, hires, and trains employees. Conducts regular touchpoint meetings, completes performance appraisals, ensures  employee competencies, and addresses employee relations issues immediately and directly. Keeps Site Director informed of all employee relations issues and other issues as necessary.
• Keeps current on changing rules and regulations regarding Medicare/Medicaid eligibilities.
• Communicates changes in regulations affecting the PACE program to Social Workers.
• Pursues relevant professional development. Attends appropriate workshops and in-services activities to maintain current professional status.
• Consistently follows Social Work Code of Ethics.
• Performs all duties in accordance with FH and Summit ElderCare policies and procedures.
 

 

Qualifications

Education: 

Master's in Social Work

 

License:

Valid and unrestricted license to practice social work from the Board of Registration of Social Work of the Commonwealth of Massachusetts (i.e., LCSW or LICSW)
 
Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage.
 
 
Experience: 

At least five years of experience in a social work capacity, preferably in a medical setting, with a minimum of 2 years of experience working with a frail or elderly population. At least 2 years of supervisory experience preferred.  

 

Competencies:
• Demonstrates commitment to the Fallon Community Health Plan Mission, Values and Vision.
• Specific competencies essential to this position:
      - Effective Communication
      - Uses Systems to Achieve Results
      - Focuses Group Efforts
      - Facilitates Change
      - Motivates Others
      - Utilization Management
      - Collaborates with Management team to meet MLR targets
      - Works with team to achieve site census targets

 

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

 

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