Licensed Clinical Social Worker - Field (Northern New Jersey)

CVS Health

1d•Hybrid

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This role will have a life-changing impact on members enrolled in Medicare and Medicaid who 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 dually eligible members to change lives in markets across the country. Help us elevate our patient care to a whole new level!

Requirements

Minimum of 2 years’ experience in medical social work or case management.
Complies with all state requirements in the state where job duties are performed.
New Jersey Licensed Clinical Social Worker (LCSW) required.
Must reside in Northern New Jersey.
Candidates must have a dedicated workspace free of interruptions.
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Nice To Haves

Bilingual Preferred.

Responsibilities

Participates in the care planning process in collaboration with the Care Manager, to include 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.
Focuses on quality of care, compliance, outcomes and decreasing costs.
Develops and carries out strategies to coordinate and integrate services to members to prevent exacerbations and/or placement of the members in custodial care.
Applies social work concepts, principles, and strategies in addressing the social determinants of health needs in members individualized care plan.
Collaborates 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 member’s 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.