Job Description
Job Description
Sign Up now for Aetna National Clinical Hiring Event! Aetna is growing and working to hire clinicians to support current and future clinical in all lines of our managed care business, including Commercial (Employer) contracts, Medicare, Medicaid and Utilization Management. We are hiring RNs, Social Workers (licensed Behavioral Health clinicians), and Case Management Coordinators with social services experience. This virtual event is on Nov 9th from 9-3pm EST. If interested in learning more or to RSVP, please clicking on this link: http://adtrk.tw/tp/rj6_cJEIU-I.K
Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members health care and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country.
Position Summary
The Social Worker participates in the care planning process in collaboration with the Care Manager, to include the following actions: assessment, goal setting, establishing interventions related to goals, identifying barriers and strategies to address, monitoring success of the interventions, evaluating the success of the overall care plan and reporting outcomes.
Fundamental Components
* Care Management activities are conducted telephonically
* Care management activities will focus on quality of care, compliance, outcomes and decreasing costs.
* Responsible for developing and carrying out strategies to coordinate and integrate post-acute and long-term care services to members to prevent exacerbations and/or placement of the members in custodial care.
* Performs initial and periodic assessments of the members enrolled in the Long-Term Care Program and/or care programs.
* Applies social work concepts, principles, and strategies in addressing the social determinants of health needs in members individualized care plan.
* Conducts regular discussion and updates with providers, primary care physicians, Medical Directors, pharmacists, and care management staff regarding the status of members and progress towards goals.
* Serves as a member advocate to ensure the member receives all the necessary care allowed under the members benefit plan and as available through Medicaid benefits and/or other community resources.
* Develops relationships with hospital social workers and community resources and utilizes available data to assure appropriate care management of catastrophic, acute, and chronically ill members with the goal of appropriate utilization, decreased length of stay, and preventable emergency room utilization.
* Assists in the identification and reporting of potential quality improvement issues.
* Directs social work interventions including performing psychosocial assessment of the populations, telephone follow up and in-home or facility assessments as indicated, documentation of problems, assessments, and/or interventions, and promoting ease of access to a continuum of care through appropriate information and referral.
Pay Range
The typical pay range for this role is:
Minimum: 45,500
Maximum: 98,000
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
- Minimum of 2 years experience in medical social work or case management.
- Licensed Social Worker (LSW, LMSW or LCSW) licensure required
Preferred Qualifications
N/A
Education
Masters Degree in Social Work
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. 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.
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