Aetna Insurance Jobs – Social Worker

Job Description:

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.

Job Responsibilities:

• 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.

Job Requirements:

• License in social work required
• Complies with all state requirements in the state where job duties are performed.
• Master’s degree must be in Social Work
• Minimum of 2 years’ experience in medical social work or case management.

Job Details:

Company: Aetna

Vacancy Type: Full Time

Job Location: Richmond, VA, US

Application Deadline: N/A

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