JUNE 10-14, 2019   •  Las Vegas, NV
Navigating the Full Spectrum of Case Management • Mirage Convention Center

PP114 – The Daily Life of a Social Worker at a Managed Care Organization (MCO)

Jun 11 2019
5:00 pm - 7:00 pm

PP114 – The Daily Life of a Social Worker at a Managed Care Organization (MCO)

The Daily Life of a Social Worker at a MCO” will deep dive into the MCO social worker role.  It will compare and contrast the role of a MCO social worker with the role of social workers in other health care settings.
It will describe the process on how a MCO social worker receives referrals and who are the referral sources. It will describe the various health care professional disciplines that the MCO social worker collaborates with on a regular basis.  This includes: acute and sub-acute discharge planners, physician’s offices, home health care agencies, mental health organizations, office on aging and disability, and many others.

This presentation will discuss various case examples.  These will illustrate the various care plan activities and goals in which the MCO social worker engages its diverse member case load. It will show how an MCO social worker may be in an ideal position in helping members optimize their continuity of care goals.
The presentation will highlight the strengths and weaknesses of doing telephonic care management versus face to face visits. The research has shown that there are various advantages and disadvantages related to telephonic versus face to face visits. The research has also shown that consumers can have a negative view of managed care organizations.  This presentation will show how a MCO social worker can successfully navigate the member relationship when a member has  these negative feelings. The presentation will explain why this can be considered a novel presentation.  This is because many MCO social workers don’t seem to typically share their daily life experiences in a seminar presentation format. The reason for this phenomenon will be discussed.
The program will be interactive and actively encourage audience participation by asking open ended questions and by having an audience exercise. This presentation will also highlight how a MCO social worker’s role is closely aligned with CMSA Standards of Practice.


1. Describe the daily life of a MCO social worker

2. Describe 360 degree care management engagement ability

3. Describe how the MCO telephonic social worker role can provide unique challenges including ethical