Transition of Care Associate - Remote - CVS Health - Aetna Team - Dual Eligible Special Needs Plan (D-SNP) Member Care

Join the CVS Health Team as a Transition of Care Associate and Make a Difference in the Lives of Our Members

CVS Health is a leading healthcare company that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world. We are seeking a compassionate and detail-oriented Transition of Care Associate to join our Aetna team, serving dual eligible populations through our Dual Eligible Special Needs Plan (D-SNP). As a Transition of Care Associate, you will play a critical role in ensuring that our members receive seamless transitions to their next care setting, and you will have the opportunity to make a life-changing impact on the lives of our members.

About CVS Health and Our Culture

At CVS Health, we are guided by a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric healthcare for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose, and we want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.

Job Summary

We are seeking a full-time remote Transition of Care Associate to join our Aetna team. As a Transition of Care Associate, you will be responsible for care coordination of our members who are experiencing a significant change in health status, which has resulted in the necessity of an emergency department visit, inpatient, skilled nursing, or rehabilitative stay. You will work closely with our members, providers, and community organizations to address the full continuum of our members' healthcare and social determinant needs.

Key Responsibilities:

• Complete post-discharge questionnaires, which may be market-specific
• Provide comprehensive discharge planning
• Ensure that members have filled/received their medications and have an understanding of how to take their ordered medications
• Provide benefit education
• Offer clinical assistance to determine appropriate services and supports due to members' health needs, including but not limited to:
  • Prior authorizations
  • Coordination with PCP and specialty providers
  • Condition management information and education
  • Medication management
  • Community resources and supports
• Evaluate health and social indicators
• Identify and engage barriers to achieving optimal member health
• Use discretion to apply strategies to reduce member risk
• Present cases at case conferences for multidisciplinary focus to benefit overall member management
• Facilitate overall care coordination with the care team to ensure members achieve optimal wellness within the confines of their condition(s) and abilities to self-manage
• Coordinate post-discharge meal delivery, assist with securing DME, and help ensure timely physician follow-up
• Understand payer/plan benefits, policies, and procedures, and articulate them effectively to providers, members, and other key personnel
• Update the care plan for any change in condition or behavioral health status

Requirements and Qualifications

Essential Qualifications:

• Active and unrestricted LPN licensure in the state of residence
• 2+ years of LPN nursing experience
• 2+ years of experience with Microsoft Word, Excel, and Outlook
• High school diploma or equivalent required; Associate's or Bachelor's degree preferred

Preferred Qualifications:

• Discharge planning experience
• Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment while providing outstanding care
• Effective verbal and written communication skills
• Bilingual a plus!

Skills and Competencies

To be successful in this role, you will need to possess the following skills and competencies:

• Strong communication and interpersonal skills
• Ability to work in a fast-paced environment and prioritize multiple tasks
• Strong attention to detail and organizational skills
• Ability to work collaboratively with a team
• Strong analytical and problem-solving skills
• Ability to adapt to changing situations and priorities

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to the growth and development of our employees. We offer a range of career growth opportunities and learning benefits, including:

• Training and development programs
• Career advancement opportunities
• Education assistance
• Free development courses

Work Environment and Company Culture

We offer a remote work environment for this position, with flexible scheduling and a range of benefits and perks. Our company culture is built on our core values of:

• Putting our members at the center of everything we do
• Delivering high-quality, patient-centered care
• Embracing innovation and technology
• Fostering a culture of inclusion and diversity

Compensation, Perks, and Benefits

We offer a competitive salary range of $21.10 - $43.78 per hour, depending on experience and qualifications. In addition to your compensation, you will be eligible for a range of benefits, including:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance plan
• Short-term and long-term disability benefits
• Paid Time Off (PTO) and paid holidays

Conclusion

If you are a motivated and compassionate individual who is passionate about delivering high-quality care to our members, we encourage you to apply for this exciting opportunity as a Transition of Care Associate. You will have the opportunity to make a life-changing impact on the lives of our members, and you will be part of a team that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world.

Apply now to join our team and start making a difference in the lives of our members!