Schedule is Monday-Friday, standard business hours. No nights, no weekends and no holidays.
Travel to local Aetna office 0-10% once COVID is lifted for meetings.
The Clinical Case manager is a licensed Clinical Social Worker position. This role partners with a registered nurse case manager to utilize a collaborative process of assessment, planning, and advocacy to meet a members benefit plan and/or health needs.
Responsibilities include researching available options and resources for members with financial, transportation, safety and housing needs. Population spans the entire lifecycle. All member contact is done telephonically or via electronic exchange. This position works to empower members to make positive lifestyle and medical choices and works as a team with other clinical staff to assist members with community resources for medical, financial and behavioral health.
Utilizes clinical judgment and critical thinking skills to help members achieve maximum physical and behavioral health through assessment and care planning, direct provider coordination/collaboration to promote effective utilization of available resources resulting in optimal, cost effective outcomes.
Utilizes motivational interviewing skills to ensure maximum member engagement.
Provides coaching, information and support to the member and the case manager assisting in order to empower the member to make ongoing independent medical and lifestyle choices.
3+ years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility
Case management and discharge planning experience
Multiple state licensure/certification preferred but not required.
Requires an licensed social worker with unrestricted active license.
Managed care/utilization review experience preferred.
Masters Degree Social Worker
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.