Social Worker (Field - Miami Dade, FL)

About the position

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and 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 DSNP to change lives in new markets across the country.

Responsibilities

• Participates in the care planning process in collaboration with the Care Manager, including 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.
• Conducts care management activities through a combination of telephonic and face-to-face interactions, including visits to member homes, in the community, facilities, and/or provider locations.
• Focuses on quality of care, compliance, outcomes, and decreasing costs.
• Develops and carries out strategies to coordinate and integrate post-acute and long-term care services to members to prevent exacerbations and/or placement of the members in custodial care.
• Performs initial and periodic assessments of the members enrolled in the Long-Term Care Program and/or care programs.
• Applies social work concepts, principles, and strategies in addressing the social determinants of health needs in members' individualized care plans.
• Conducts regular discussions and updates 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 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.
• Assists in the identification and reporting of potential quality improvement issues.
• Directs social work interventions including performing psychosocial assessments, telephone follow-ups, and in-home or facility assessments as indicated.

Requirements

• Must possess active and unrestricted LMSW licensure in the state of Florida.
• Minimum of 2+ years experience in medical social work or case management.
• Must be willing and able to travel up to 75% of the time in the Miami Dade County area.
• Reliable transportation required.
• Must reside in or near Miami Dade county.

Nice-to-haves

• Bilingual a plus (English / Spanish).

Benefits

• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Numerous well-being programs.
• Education assistance.
• Free development courses.
• CVS store discount.
• Paid Time Off (PTO) or vacation pay.
• Paid holidays throughout the calendar year.