Spotlight On…VNSNY CHOICE Social Workers!
Anthony Brown — Clinical Support Social Worker, CHOICE SelectHealth
I’m primarily a behind-the-scenes member of the business/clinical administrative staff at CHOICE Health Plans. I am a social worker and I’m also an attorney. Drawing on these two degrees, as an internal auditor, I review letters sent to members by Beacon, our behavioral health vendor for CHOICE SelectHealth members, explaining Beacon’s authorizations or denials of services. I try to make sure that the appropriate steps were taken based on mental health law, the narrative of the letter, and the files related to the member’s episodes of care, and that timely decisions were made. I also suggest changes so that future letters are easier to understand. I coordinate with VNSNY CHOICE Compliance, our Vendor Relations, and Beacon, to enhance the auditing process and Beacon’s letters to our members.
At times I work directly with members in crisis, in coordination with Beacon, ensuring that necessary behavioral health services are provided to optimize psychosocial functioning and ensure safety. I also help research, prepare for, and participate in DAC (Division of AIDS Center) conferences, during which CHOICE multidisciplinary staff coordinate with treatment teams from in-network hospitals/DACs to address gaps in care, targeting members lost to follow-up—bringing them back into treatment and leading viral load non-suppressed members towards undetectable status. I love being a part of VNSNY and CHOICE, helping to make sure optimal services are provided for each member, and being involved in improving business/clinical processes.
Clarene Richards — Lead Social Worker, CHOICE FIDA
I work with my members and their families telephonically. Of the members I’m currently managing, 90 percent have mental health diagnoses. I might speak to them this month to assist them with food stamps, and next month another issue may emerge such as housing or depressive symptoms. My goal is to help CHOICE members manage and be maintained in their homes and communities. My job is not just to advocate for them, but also to educate and empower them. If you empower people to understand an issue and reason their way through it, when a new issue arises they’re better prepared to manage that new issue.
The psycho-social assessments we do are also helpful, because you get a really good snapshot of the whole family history—parents, children, grandparents—to figure out how you can best work with them. I have two degrees, an MA in sociology and an MSW, that I think give me a good perspective in understanding the study of human social behavior, and social change and development. I believe we need to treat the people we’re helping the way you would treat a member of your family. Social work is a profession of helping and caring through social changes and development.
Belgica Rosario — CHOICE Clinical Support
I interact with mostly elderly CHOICE members and their families by phone to help get them the care and community resources they need to be stable at home. I receive 8 to 10 new referrals a day, plus follow-up calls to existing referrals. Case conferences with the nurse practitioner and provider are helpful in understanding what kind of assistance the plan member might need. I address many different types of problems. For instance, if a member is depressed, I’ll discuss with them and their family whether they would like to have counseling in the home. Recently a member’s landlord was abusive, and I worked with Social Services to relocate her into other housing.
I‘ve learned that listening is big—comprehending the issue and showing that you understand and support the client. I find that my being able to speak Spanish helps a lot. I think the most important skill in this job is empathy. When I’m able to understand the member’s pain and put myself in their situation, it doesn’t fix the problem, but they feel much better having someone to talk to. It’s rewarding to me seeing how one conversation can help change someone’s life. Whatever we can do to make their life feel easier, we’ll do.
To view more profiles celebrating VNSNY Social Workers, click here.