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CVS Health

Runs pharmacies, health plans and clinics

Case Manager

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeMichigan, USA

About the Job

Requirements

  • A minimum of 2 years of experience in medical social work or case management is required.
  • Comply with all state requirements in the state where job duties are performed.
  • Be willing and able to travel up to 25%–50% of the time in Wayne and Macomb Counties; reliable transportation is required.
  • Have basic awareness of problem-solving and decision-making skills.
  • Have basic awareness of digital literacy skills.
  • Have basic knowledge of medical terminology.
  • Be able to deal tactfully with customers and the community.
  • Be able to handle sensitive information ethically and responsibly.
  • Be able to consider the relative costs and benefits of potential actions to choose the most appropriate option.
  • Be able to function in a clinical setting with diverse cultural dynamics among clinical staff and patients.
  • Hold a Bachelor's Degree in Social Work as required by state law.
  • Hold one of the listed social work licenses: LLBSW, LBSW, or LLMSW.

Responsibilities

  • Coordinate care for members with long-term rehabilitation or psychosocial needs to help prevent exacerbations, readmissions, or placement into custodial care.
  • Implement and coordinate case management, psychosocial, and quality-of-life activities across the continuum of care, including consultant referrals, home care visits, community resources, and alternative levels of care.
  • Develop and carry out strategies to coordinate and integrate acute and long-term care services for members receiving case or disease management.
  • Provide psychosocial interventions through resource identification, program development, and other means.
  • Control comprehensive management of members with acute or chronic conditions, including case management activities focused on quality of care, compliance, outcomes, and reducing costs for individuals and communities.
  • Implement initial and periodic assessments of members enrolled in the Long-Term Care Program or case or disease management programs to determine their course of treatment.
  • Apply in-depth knowledge of case management concepts, principles, and strategies to develop individualized case plans for enrolled members at risk of poor outcomes.
  • Communicate updates and facilitate discussions with providers, primary care physicians, Medical Directors, pharmacists, and care management staff about patient status internally and externally.
  • Identify opportunities to ensure members receive necessary care allowed under their benefit plans in home or community settings.
  • Provide information, resources, and education on social issues, mental health, and available services to raise awareness and empower individuals and communities.
  • Develop complex, innovative programs to reduce admissions for acute and chronic members, increase community integration, and improve health outcomes for enrolled patients and others.
  • Coach junior colleagues in social work techniques, processes, and responsibilities to improve capacity.
  • Collaborate with community members, organizations, and policymakers to create opportunities for clients, address community issues, or raise awareness of specific issues.

Desired Qualifications

  • Behavioral health experience.
  • Bilingual ability in Spanish or Arabic.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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