Medical Social Worker

Proactive MD partners with companies to provide their people with employer-sponsored onsite wellness centers, decreasing costs and making their healthcare benefits more efficient. We provide broad-scope Advanced Primary Care by building relationships with our patience and practicing medicine the way it was meant to be: Compassionate, committed, and comprehensive.

Job Summary

The mission of the Medical Social Worker, known internally as a Patient Advocate, is to facilitate and ensure continuity in patient care and serve as a conduit of care between the services of the health center and into the community. The Patient Advocate will strategically engage employees and their dependents before, during, and after visits to the center in order to ensure we are providing personalized, informative, and compassionate care. The Patient Advocate role is supported by and reports to the Patient Advocacy, National Manager. The individual will work closely with the Client Relations, Clinical Operations team, Health Center Provider, and Client HR Team.

Clinic Address: 1100 S. St. Francis Drive, Suite 1000, Santa Fe, NM 87505

Position Hours: Monday - Friday 8am to 5pm

Essential Duties and Responsibilities

• Patient Outreach & Engagement
• Coordination of Care
• Benefits Concierge & Resource Navigation
• Medical Social Services
• Home & Site Visits
• Behavioral & Mental Health Support
• Chronic Condition Management & Referrals

Essential Duties and Responsibilities

The role of the patient advocate is a dynamic and varied role and may include some or all of the following responsibilities. Patient advocates work on a clinical team with shared responsibilities and are not solely responsible for all tasks noted in this job description.

Coordination of Care

Under the direction of the Provider, the Patient Advocate will coordinate care with external specialists, imaging centers, labs, medical equipment providers, counselors, community resources, etc.

Ensure electronic medical records are provided to Proactive MD’s Provider following any specialist visit and that Provider records are sent to specialists prior to patient visit.

Receive prior authorizations required by the insurance company for tests or procedures and, as appropriate to the Health Center, send prior notification to insurance regarding procedures or referrals.

Continuously refine and update the list of value-based providers suitable for referral in the community the Health Center serves.

Assist patients in navigating the healthcare system.

Coordinate care when a patient is admitted and discharged from the emergency room or hospital. Ensure Proactive MD’s Provider is included in the aftercare process.

Visit hospitalized patients to ensure care coordination is directed by the Provider.

Patient Engagement

Engage with patients to encourage use of the Health Center (high-risk dashboard or patient engagement dashboard)

Encourage and coordinate follow-up visits at the Health Center.

Work in coordination with the on-site Provider, Client Relations, and Client representative to develop outreach campaigns and educational resources. The Patient Advocate is responsible for the execution and success of these campaigns

Represent the Health Center at internal and external meetings and events.

Encourage completion of patient survey at the end of each Health Center encounter.

Text/email/mail patient communications regarding significant events (birthdays, get well, condolences, congratulations, etc.)

Patient Education

Be knowledgeable about and provide information to patients regarding available community services that could enhance their care.

Coordinate patient care and treatment plans; provide educational materials/consultation; follow up on patient well-being.

Assist patients using individual appointments in understanding benefits available to them through their health insurance program (EAP etc.)

Health Center Synergy

Coordinate with Clinical Operations in times of high Health Center utilization to ensure that patients are greeted, checked in, and roomed, and phones are answered.

Engage with the provider in the role of “embedded” case manager for optimal utilization of skills and abilities.

• Encourage patient completion of tablet-based patient satisfaction surveys.
• Participate in any Health Center-wide meetings to ensure excellent cross-communication and collaboration.
• Required

2+ years of experience working in healthcare setting, Medical or Healthcare Social Work in similar setting, or Case Management role.

• Bachelor of Social Work Degree, or degree in a related field such as Sociology, Psychology, or Counseling
• Knowledge of the healthcare industry, available patient resources, and medical case management
• Knowledge of HIPPA confidentiality requirements

Proactive MD is firmly committed to creating a diverse workplace and is proud to provide equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender identity and/or expression, sexual orientation, ethnicity, national origin, age, disability, genetics, marital status, amnesty status, or veteran status applicable to state and federal laws.