Social Worker Specialist at Alivia Health

Job Description:

Latest job information from Alivia Health for the position of Social Worker Specialist. If the Social Worker Specialist vacancy in Guaynabo matches your qualifications, please submit your latest application or CV directly through the updated Jobkos job portal.

Please note that applying for a job may not always be easy, as new candidates must meet certain qualifications and requirements set by the company. We hope the career opportunity at Alivia Health for the position of Social Worker Specialist below matches your qualifications.

Job Description

The Social Worker in the Specialty Pharmacy provides psychosocial support, care coordination, and patient advocacy for individuals with chronic and complex conditions. The Social Worker will not directly manage insurance plans, but the role requires a robust understanding of healthcare financial processes and Social Determinants of Health. This specialized knowledge is critical for effectively navigating and resolving patient barriers related to financial hardship, and equitable access to necessary and comprehensive care. The Social Worker coordinates referrals both within the pharmacy and with external providers to ensure comprehensive care.

Key Responsibilities

Patient Support & Case Management

• Conduct psychosocial assessments to identify social, emotional, financial, and environmental needs impacting treatment.
• Develop individualized care plans to address barriers to adherence and overall well-being.
• Provide emotional support, counseling, crisis intervention, and linkage to community resources.

Care Coordination & Referral

• Serve as coordinator for internal patient referrals, from pharmacists, clinical support teams, nursing staff, and other pharmacy operation staff.
• Coordinate referrals outside the pharmacy to mental health providers, specialists, community agencies, transportation programs, and other social services
• Follow up on referrals to ensure patients receive the intended services and support.

Financial Access & Insurance Support (Non-administrative)
Note: This role does not process or manage insurance plans.

• Assist patients in understanding financial challenges related to treatment costs and available support options
• Provide guidance on accessing financial assistance programs, charity resources, and community-based aid
• Support patients through insurance barriers by:
  1. Educating them on the appeal or reconsideration process.
  2. Helping them gather necessary documentation
  3. Collaborating with pharmacy benefits teams or case managers responsible for insurance processing.
  4. Advocate on behalf of patients to ensure equitable access to medication and treatment.

Advocacy & Education

• Educate patients and caregivers about treatment expectations, support programs, and community resources
• Advocate internally and externally to help resolve barriers to care and improve patient experiences.
  

Documentation & Compliance

• Maintain accurate and timely documentation of assessments, interventions, referrals, and follow-ups.
• Comply with HIPAA standards and all organizational guidelines.
• Participate in quality improvement initiatives related to patient outcomes and service delivery.

QualificationsRequired
Bachelor’s or Master’s degree in Social Work (BSW/MSW).
State licensure (LSW, LMSW, LCSW, or equivalent).
Experience supporting patients with chronic or complex health conditions.Preferred
Experience in healthcare, specialty pharmacy, or case management.
Familiarity with financial assistance programs, insurance appeals, and access-to-care resources.
Strong interpersonal, organizational, and communication skills.
Bilingual capability (a plus).Core Competencies
Empathy and cultural sensitivity
Strength in care coordination and referral management
Advocacy and problem-solving
Knowledge of financial hardship and insurance-related barriers
Strong documentation and organizational skills
Ability to work collaboratively with interdisciplinary teams

**EEOC F/M/V/D**

Job Info:

• Company: Alivia Health
• Position: Social Worker Specialist
• Work Location: Guaynabo
• Country: US

How to Submit an Application:

After reading and understanding the criteria and minimum qualification requirements explained in the job information Social Worker Specialist at the office Guaynabo above, immediately complete the job application files such as a job application letter, CV, photocopy of diploma, transcript, and other supplements as explained above. Submit via the Next Page link below.