Transitional Care Manager, Social Work – LSW or LCS Required

Job not on LinkedIn

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $43.9k - $91.1k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Manage patients through transitions of care face to face in facilities or telephonically within a defined geographical area and care setting • Advocate for patients throughout the care continuum and resolve barriers to care • Establish relationships with patients, families, providers, and care teams • Explain patient condition, care and discharge plans, instructions, medication reconciliation, utilization management determinations, and financial information • Identify opportunities to improve workflows, partnerships, and patient care quality • Maintain real-time, accurate patient transition records in Oak Street’s internal inpatient platform • Adhere to CMS, state-specific, and NCQA transitions-of-care compliance criteria • Coordinate with Utilization Management to review records, assess length of stay, and identify discharge barriers • Participate in inpatient and post-acute rounding calls • Collaborate with transitional care, care navigation, utilization management, social work, behavioral health, and other internal teams • Engage inpatient physicians, case managers, medical directors, social workers, and SNFists to facilitate safe discharge and follow-up care • Participate in meetings concerning program implementation, development, clinical learning, and system improvements • Participate in training and quality assurance activities • Document and track transitions interventions • Perform other duties as assigned

🎯 Requirements

• Indiana LSW or LCSW required • Willingness to obtain cross-state licensure, as needed • Certified Case Manager (CCM) required, or willingness to obtain within 12 months of hire • Minimum of 2 years of experience in transitional social work, discharge planning, or home health • Experience in utilization management preferred • Knowledge of Medicare/Medicaid and NCQA regulatory transitions of care criteria • Exceptional communication skills and customer service orientation • Innovative and independent problem solving skills • Ability to monitor and evaluate opportunities for cost-effective care options with high-quality outcomes • Spanish-speaking preferred but not required • Flexible, positive attitude • Access to reliable transportation with the ability to travel daily • Working knowledge of Microsoft Office Product Suite • US work authorization • Someone who embodies being Oaky

🏖️ Benefits

• Paid vacation and sick time • Generous 401K match with immediate vesting • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility