At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Program Overview
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.
 
Position Summary
The Social Worker participates in the care planning process in collaboration with the Care Manager, to include the following actions: 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.
 
Fundamental Components

 Care Management activities are conducted through a combination of telephonic and face to face interactions which include visits to member homes, in the community, and/or provider locations.Care management activities will focus on quality of care, compliance, outcomes and decreasing costs. Responsible for developing and carrying 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 plan. Conducts regular discussion 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 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.

 
 
Required Qualifications 

Candidate must reside in Westchester County, NYMinimum of 2 years’ experience in medical social work or case management.NY License in Social WorkComplies with all state requirements in the state where job duties are performed.Must possess reliable transportation and be willing and able to travel up to 75-90% of the time within a 50 mile radius. Mileage is reimbursed per our company expense reimbursement policy

Education

Master's Degree in Social Work 

Certification

NY License in Social Work

Anticipated Weekly Hours

40

Time Type

Full time

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. 
 

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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/28/2025

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