Social Worker – Utilization Management Team

Harbor HealthAustin, TX

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Overview

Schedule

Full-time

Education

Social Work (LSW, LMSW, LICSW)

Career level

Senior-level

Job Description

Social Worker – Utilization Management Team

COMPANY OVERVIEW

At Harbor Health, we’re transforming healthcare in Texas through collaboration and innovation. We’re seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you’re ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!

POSITION OVERVIEW

*Candidate should reside in Austin

The Social Worker supports the Utilization Management (UM) team by addressing psychosocial, behavioral health, substance use, and social needs that impact members’ health outcomes and care utilization. This role focuses on identifying barriers to care, supporting members with behavioral health and substance use concerns, and addressing Social Determinants of Health (SDOH).

The Social Worker collaborates with members, HHIC UM nurses, care managers, providers, and community organizations to ensure members receive coordinated, person-centered care and are connected to appropriate healthcare and community-based resources.

POSITION DUTIES & RESPONSIBILITIES

Psychosocial & Behavioral Health Support

Conduct psychosocial assessments for HHIC (Harbor Health Insurance Company) members identified through UM reviews who may have behavioral health, mental health, substance use, or complex social needs.
Identify psychosocial barriers that may affect treatment adherence, recovery, or access to services.
Provide support and care coordination for members experiencing behavioral health or substance use challenges.
Collaborate with behavioral health providers, substance use treatment providers, and primary care teams to support appropriate care.
Assist in identifying appropriate levels of care and support services for members when needed.

Social Determinants of Health (SDOH) Support

Assess members for social needs such as housing instability, food insecurity, transportation barriers, financial hardship, and other social factors affecting health.
Connect members to community resources, social service programs, and support services.
Coordinate referrals to community organizations, social service agencies, and recovery support programs as appropriate.
Support members in navigating healthcare and community systems to access needed services.

Care Coordination & UM Team Collaboration

Collaborate with UM nurses, the HHMG (Harbor Health Medical Group) Acute & Complex Care Team (ACT) team, and other resources, including pharmacy, to ensure comprehensive, holistic care for members.
Participate in case reviews and care planning discussions for members with complex needs.
Assist with member outreach, engagement, and education regarding available services and resources.
Engage in face-to-face interactions with providers and members to assess and support social work–related member needs
Support efforts to improve care coordination and address barriers that may impact healthcare utilization.

Documentation & Compliance

Maintain timely and accurate documentation in applicable UM and Care Management (CM) e.g. PA Tracker Google Sheet, Athena EHR, etc. systems.
Ensure compliance with organizational policies, regulatory requirements, and privacy standards.
Track and report activities related to psychosocial interventions and community resource referrals as required.

REQUIRED QUALIFICATIONS

Active Social Work license (LMSW)
At least five years experience working with individuals experiencing behavioral health, substance use, or complex social needs.
Reside in the Austin area and have knowledge of Austin-area community resources and social service systems.
Strong communication, assessment, and care coordination skills.
Ability to support occasional in-person interactions with providers and members in the Austin area.

PREFERRED QUALIFICATIONS

Experience in managed care, health plans, or utilization management.
Familiarity with Social Determinants of Health (SDOH) screening and interventions.
Experience working with diverse or high-risk populations.
Knowledge of Texas social service programs for members in need both local and state-wide preferred
Familiarity with NCQA processes and requirements

Key Competencies

Member-centered and trauma-informed approach
Behavioral health and substance use awareness
Resource navigation and community engagement
Interdisciplinary collaboration
Cultural competency
Problem solving and advocacy
Motivational interviewing and effective communication – building trust and encouraging member engagement
Relationship-building and rapport development – establishing supportive, lasting connections
Empowerment and self-advocacy support – guiding members to make informed decisions about their care

Harbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive environment for all clinicians and teammates and actively encourage applications from people of all backgrounds.

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FAQs About Social Worker – Utilization Management Team Jobs at Harbor Health

What is the work location for this position at Harbor Health?

This job at Harbor Health is located in Austin, TX, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Harbor Health?

Employer has not shared pay details for this role.

What employment applies to this position at Harbor Health?

Harbor Health lists this role as a Full-time position.

What experience level is required for this role at Harbor Health?

Harbor Health is looking for a candidate with "Senior-level" experience level.

What education level is required for this job?

The education requirement for this position is Social Work (LSW, LMSW, LICSW). Candidates with relevant qualifications or equivalent experience may also be considered.

What is the process to apply for this position at Harbor Health?

You can apply for this role at Harbor Health either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.