Care Coordinator Social Worker , DVACO - Radnor (Altoona)


: $51,306.67 - $78,130.00 /year *

Employment Type

: Full-Time


: Social Services/Counseling

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Delaware Valley Accountable Care Organization(DVACO), located in Radnor, PA has a newly created opportunity for Care Coordinator Social Worker.

The DVACO isa limited liability joint venture corporation comprised primarily of two majorhealth systems: Jefferson Health and Main Line Health, serving the GreaterPhiladelphia region and southern New Jersey. DVACO was accepted into theMedicare Shared Savings Program for the 2014 start year, and now includes 2,000physicians serving over 180,000 lives. DVACO contracts with four commercialpayers and serves Medicare beneficiaries, making it the region's largestAccountable Care Organization. At the core of operations, DVACO is committed toworking towards the achievement of the triple aim: better outcomes, betterexperiences, and smarter spending. Our culture embraces innovation ofhealthcare delivery models through collaborative work with physician practices,health systems and employee wellness programs. To learn more, please goto .

Why Work for Main Line Health?

We are committed to providing exceptional care with empathyand compassion for people at all stages in life. Our Diversity, Respect andInclusion Initiative celebrates our differences and our similarities.Ultimately, we want everyone to feel respected for who they are.

The Care Coordinator is a SocialWorker who facilitates patient continuity of care with the healthcare team.Under the clinical direction and oversight of the Primary Care Physician, theCare Coordinator coordinates care for high risk/complex patients bycollaborating with the patient, family, physician, nurses, and other members ofthe healthcare team to identify needs and expedite appropriate, cost effectivecare. TheSocial Worker partners with the RN Care Coordinator to facilitate the caremodels of DVACO by coordinating services and community resources and meetingmember socioeconomic needs to support the quality of life. S/he assistsin the development of the patient's care plan and collaborates with the PrimaryCare Physician to provide leadership in issues of outcomes management, diseasemanagement and prevention, and development of improved strategies to benefithigh risk patients. The Care Coordinator may serve as the patient's primaryconduit to the primary care provider as they help coordinate necessary servicesboth within and outside the practice, coordinating care from a varietyof sources - physicians, specialists, home care providers, rehab centers,pharmacists, etc. They will engage patients andencourage them to take an active role in their health by providing them withthe tools necessary to make healthy lifestyle choices and adopt life-longhealthy behaviors. The social worker will serve as an advisor to the clinicalteam for health and human services resources as well as guardianship andbehavioral health issues.

Education: Master's Degree in Social Work from CSWE (Council on Social WorkEducation) accredited program.

Licensures &Certifications :

Case Manager (CCM)certification (preferred)


5 Years Experience in hospital or community clinic,home care, discharge planning, and/or case management required

3 years experience in a managed care environmentpreferred

Prior ACO experience preferred

Minimum 2 years experience working with frail orelderly population

Strong behavioral health background

Ability to interact with physicians and other healthcare professional in a professional manner required

Ability to work independently

Computer proficiency required.

Excellent verbal and written communication andinterpersonal skills required

Ability to prioritize daily tasks and caseloadactivities to meet patient needs and turnaround times

Knowledge ofmanaged are models financial reimbursement systems, clinical case management processesand utilization management issues

Knowledge of NCQA(PCMH) guidelines for care management

We offer competitive compensation andoutstanding comprehensive benefits including tuition reimbursement, 403Bmatching savings plan and a pension plan.

Associated topics: abuse, advocate, casework, counselor, insights, lcsw, msw, outreach, tirr, youth * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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