Licensed Clinical Social Worker - Contract

Contract Role Overview

Carewell is looking for a Licensed Clinical Social Worker to serve as the primary logistical architect for patients and their family caregivers. Your mission is to navigate the complexities of the Medicare system to ensure patients receive seamless, cost-effective, and well-coordinated care. You will not perform clinical diagnoses or therapy; instead, you will act as a high-level project manager for the patient’s health journey, managing everything from specialist synchronization to medication cost-containment.

What You’ll Do 

• Medicare Navigation: Provide expert guidance on Medicare, benefits, and enrollment logistics. 
• Billing & Insurance Advocacy: Review Medicare Summary Notices (MSNs) and Explanation of Benefits (EOBs) for errors. File appeals for denied services and resolve billing disputes with providers.
• Care Coordination & Logistics: Schedule and manage specialist visits, telehealth setups, and transportation logistics, and ensure that records are shared between offices to prevent redundant testing.
• Financial Advocacy: Identifying medical billing errors, negotiating costs, and finding pharmaceutical assistance programs to reduce out-of-pocket medication expenses.
• Caregiver Support: Act as a single point of contact for the family, providing updates and educational resources to help them make informed decisions without the stress of navigating the red tape themselves.
• Resource Connection: Identify and vet non-medical community resources, such as specialized transportation, meal delivery (e.g., Meals on Wheels), and respite care for families.

What You’ll Need

• Experience: A minimum of two years experience directly working in a non-clinical social worker environment, specifically within care coordination. 
• Licensure: Active Social Work license (LSW, LMSW, or equivalent). While the role is non-clinical, a social work background is required for systems-level thinking and ethics.
• Subject Matter Expertise: Deep, verifiable knowledge of Medicare regulations, Medigap, and the nuances of prescription coverage.
• Technical Proficiency: Ability to manage complex cases via CRM/Case Management software and conduct high-quality video consultations.
• Skills: Exceptional negotiation skills (for insurance/billing disputes) and the ability to translate "doctor-speak" into actionable plans for families.