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Program Overview
Join our Aetna team as we lead the way in providing exceptional care to dual eligible populations! This role involves up to 65% 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.

Position Summary
As a field Social Worker, you will play a vital role in the member-centered care planning process alongside the other core care team members. Your responsibilities will include:

• 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.

Fundamental Components

• 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.

Required Qualifications

• Candidate must reside in Gwinnett County, Georgia (GA)
• Candidate must have active and unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Master's Social Worker (LMSW) in Georgia
• Ability to travel up to 65% within a designated geographic area for in-person case management activities (Travel expenses are reimbursed in accordance with the company travel reimbursement policy)
• 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
• Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted

Preferred Qualifications

• 2+ years of experience in medical social work or case management

Education

• Bachelor's of Social Work Degree (REQUIRED)
• Master's of Social Work (PREFERRED)

License

• Active and unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Master's Social Worker (LMSW) in Georgia

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.