Social Worker - Field Charleston, WV

CVS Health•Work At Home-West Virginia, WV

1d•$43,888 - $91,052•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. Join our Aetna team as we lead the way in providing exceptional care to dual eligible populations! This role involves 50-75% travel. You will have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid and face a variety of complex health and social challenges. Through compassionate engagement and effective communication, we work collaboratively with members, healthcare providers, and community organizations to address the comprehensive healthcare and social needs of our members. Be part of this exciting opportunity as we expand our DSNP services to transform lives in new markets across the country.

Requirements

Minimum of 2 years of experience in medical social work or case management is preferred.
Ability to travel within a designated geographic area for in-person case management activities.
Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the Social Worker role.
Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually.
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position.
Candidate licensure must comply with requirements in the state where job duties are performed.

Nice To Haves

Master of Social Work is preferred.

Responsibilities

Conducting field visits to the member’s home, community locations, medical facilities, and other locations.
Completing care management focused assessments.
Setting member-centered goals.
Identifying barriers and strategies to address them.
Establishing, monitoring, and adapting interventions to achieve member goals.
Focus on enhancing quality of care, ensuring compliance, improving outcomes, and reducing costs.
Develop and implement strategies to coordinate and integrate post-acute and long-term care services, preventing exacerbations and unnecessary custodial placements.
Perform initial and ongoing assessments for members enrolled in the Long-Term Care Program and other care initiatives.
Utilize social work principles and strategies to address the social determinants of health within each member’s individualized care plan.
Collaborate and facilitate ongoing communication with providers, primary care physicians, Medical Directors, pharmacists, and care management staff to discuss member status and progress toward goals.
Advocate for members to ensure they receive all necessary care covered by their benefit plans and available through Medicaid and community resources.
Build relationships with hospital social workers and community resources, leveraging data to ensure effective management of catastrophic, acute, and chronically ill members, aiming for appropriate utilization and reduced lengths of stay.
Assist in identifying and reporting potential quality improvement opportunities.
Direct social work interventions, including psychosocial assessments, follow-ups, in-home or facility assessments, documentation of issues and interventions, and facilitating access to a continuum of care through appropriate referrals.