Aetna Social Worker (LCSW) in Albuquerque, New Mexico
Req ID: 54554BR
This role is telework with 75-100% of field based travel in Albuquerque, NM.
This is your opportunity to join an organization that is reshaping healthcare! Aetna is about meeting our members where they are and working to improve their lives, one person at a time!
Come help us make a difference!
*Candidates must be willing and able to travel daily in Albuquerque, New Mexico area.
Fundamental components include but are not limited to:
The Social Worker, works within a Care Team setting, and is responsible for supporting member-centered care management across the health care continuum, to ensure services are being provided to, members and their families. Provides assessments that address social and behavioral health outcome indicators. Addresses social determinants of health and actively participates in the members plan of care, to promote effective utilization of plan benefits, available resources, supports optimal member functioning, while assuring cost-effective outcomes.
Utilizes professional clinical judgment and advanced clinical skills in completing assessments of referred member needs/review of member-specific health information; determines an approach to resolve member issues/meeting needs by evaluating the members benefit plan & available internal/external programs/services/resources
Incorporates strategies designed to reduce risk factors & barriers; address clinical indicators & barriers which impact care planning/resolution of member issues
Prioritizes members experiencing acute behavioral health/medical issues & refers to the appropriate clinical/service providers for thorough assessment & treatment
Conducts in person assessments & consultations with members/families
Provides crisis follow up to members and their families to ensure they are receiving the appropriate treatment and services
Makes timely contact with the Member; provides services in accordance with the approved Social Work policy and documents all communications within 24 hours of member contact
Using a holistic approach consults with clinical colleagues, managers, Medical Directors, other ICT members & other programs to overcome barriers to meeting goals/objectives.
Collaborates w/medical & behavioral health professionals and present cases at case rounds to coordinate member care
Identifies/escalates member safety & quality of care issues through established
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement; promotes lifestyle/behavior changes to achieve optimum level of health
Provides coaching, information & support to empower the member to make ongoing independent medical/healthy lifestyle choices and fully participate w/their provider in healthcare decision-making
-Maintains a comprehensive working knowledge of community resources, payer requirements and network services
The minimum level of education required for candidates in this position is a Master's degree
Licenses/ Certifications: Licensed Clinical Social Worker (LCSW); active and in good standing is required
3+ years clinical practice experience, e.g., community, public health, hospital setting, alternative care setting such as home health or ambulatory care required
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications required
Ability to travel within a designated geographic area required
Case management, behavioral health, discharge planning experience preferred
Managed Care, Medicare/Medicaid experience preferred
Crisis intervention skills preferred
Bilingual (Spanish, Creole and/or Vietnamese) preferred
The minimum level of education desired for candidates in this position is a Master's degree.
LICENSES AND CERTIFICATIONS
Mental Health/Licensed Clinical Social Worker is required
Functional - Medical Management/Medical Management - Case Management/4-6 Years
Functional - Medical Management/Medical Management - Hospice/1-3 Years
Functional - Medical Management/Medical Management - Discharge planning/1-3 Years
Functional - Medical Management/Medical Management - Clinical coverage and policies/1-3 Years
Functional - Medical Management/Medical Management - Home health care/1-3 Years
Technical - Remote Access/WAH (Work at Home)/1-3 Years/End User
Technical - Call Management//1-3 Years/End User
Technical - Telecommunications//1-3 Years/End User
Benefits Management/Encouraging Wellness and Prevention/ADVANCED
Benefits Management/Maximizing Healthcare Quality/ADVANCED
Benefits Management/Understanding Clinical Impacts/ADVANCED
Benefits Management/Interacting with Medical Professionals/ADVANCED
General Business/Applying Reasoned Judgment/ADVANCED
Leadership/Collaborating for Results/MASTERY
Telework is a requirement for this position (no physical office location). Time will be split between working at home and visiting members in the field.
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Health Care
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.