Social Worker-Field- Queens

Program Overview

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.

Position Summary

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.
• Sets member-centered goals.
• Identifies barriers and strategies to address them.
• Establishes, monitors, and adapts 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. 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 Abilities

• Ability to travel within within a reasonable distance to Queens and surrounding areas for in-person case management activities up to 75% of the time. 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.

Preferred

• Minimum of 2 years of experience in medical social work or case management.
• Driver's license and own transportation.

Education & Certification Requirements

• Master of Social Work
• NYS LMSW or LCSW

Pay Range

The Typical Pay Range For This Role Is $51,256.00 - $111,351.00 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.