Case Manager, Social Worker - Field-MI (Wayne and Macomb County)

CVS Health • Canton, MI

5d • $46,597 - $101,228 • Remote

About The Position

The Case Manager, Social Worker coordinates care for members with long-term rehabilitation or psychosocial needs related to birth defects, chronic conditions, illness, or injury. The role aims to prevent exacerbations, readmissions, and placement in custodial care. It implements and coordinates case management, psychosocial, and quality-of-life activities across the continuum of care, including consultant referrals, home care visits, community resources, and alternative levels of care. The position develops strategies to coordinate acute and long-term care services for members involved in case and disease management and provides psychosocial interventions through resource identification, program development, and other means. The role may specialize in a disease area and may consult with other health care professionals.

This is a work-at-home role with 25–50% travel throughout Wayne and Macomb Counties. The schedule is Monday through Friday, 8:00 AM to 5:00 PM, with 40 anticipated weekly hours.

Requirements

• At least 2 years of experience in medical social work or case management.
• Comply with all state requirements in the state where job duties are performed.
• Willingness and ability to travel 25–50% of the time in Wayne and Macomb Counties.
• Reliable transportation.
• Basic awareness of problem-solving and decision-making skills.
• Basic awareness of digital literacy skills.
• Basic knowledge of medical terminology.
• Ability to deal tactfully with customers and the community.
• Ability to handle sensitive information ethically and responsibly.
• Ability to weigh the relative costs and benefits of potential actions to choose an appropriate option.
• Ability to function in a clinical setting with diverse cultural dynamics among clinical staff and patients.
• Bachelor’s degree in Social Work, as required by state law.
• LLBSW, LBSW, or LLMSW.

Nice To Haves

• Behavioral health experience.
• Bilingual in Spanish or Arabic.

Responsibilities

• Manage members with acute or chronic conditions, focusing on quality of care, compliance, outcomes, and reducing costs.
• Conduct initial and periodic assessments of members in Long-Term Care, case management, or disease management programs to determine a course of treatment.
• Develop individualized case plans for enrolled members at risk of poor outcomes, applying case management concepts, principles, and strategies.
• Communicate updates and facilitate discussion about patient status with providers, primary care physicians, Medical Directors, pharmacists, and care management staff, internally and externally.
• Identify opportunities to ensure members receive necessary care covered by their benefit plan in home or community settings.
• Provide information, resources, and education about social issues, mental health, and available services.
• Develop programs to reduce admissions, increase community integration, and improve health outcomes.
• Coach junior colleagues in social work techniques, processes, and responsibilities.
• Collaborate with community members, organizations, and policymakers to create opportunities for clients, address community issues, and raise awareness.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.
• Eligibility for a CVS Health bonus, commission, or short-term incentive program in addition to base pay.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level