Aetna Social Worker in High Point, North Carolina

Req ID: 49131BR

Position Summary:

The Clinical Case manager is a licensed Social Worker position. This role partners with a registered nurse case manager to utilize a collaborative process of assessment, planning, and advocacy to meet a members benefit plan and/or health needs. Responsibilities include researching available options and resources for members with financial, transportation, safety and housing needs. Population spans the entire life cycle. All member contact is done telephonically or via electronic exchange. This position works to empower members to make positive lifestyle and medical choices and works as a team with other clinical staff to assist members with community resources for medical, financial and behavioral health. Requires an LCSW or MSW with unrestricted active license.

Great opportunity for a MSW to work with an integrated clinical team to produce effective positive and healthy outcomes for our members. Effective time management and organizational skills along with the ability to manage continually changing priorities is needed. The ideal candidate should have excellent written and verbal communication skills and proficiency with computers. Computer skills include navigating multiple systems and web-based applications, use of a mouse, and strong keyboarding skills. Familiarity with Microsoft Word, Excel and Outlook and the ability to copy and paste is a necessity. This is a telephonic position and may require sitting for extended periods of time. This position is full time Monday-Friday 8:30-5p with the flexibility to speak with members later hours based on the members availability.

Additional Job Responsibilities:

  • Utilizes clinical judgment and critical thinking skills to help members achieve maximum physical and behavioral health through assessment and care planning, direct provider coordination/collaboration to promote effective utilization of available resources resulting in optimal, cost effective outcomes

  • Utilizes motivational interviewing skills to ensure maximum member engagement

  • Provides coaching, information and support to the member and the case manager assisting in order to empower the member to make ongoing independent medical and lifestyle choices


  • Minimum of 3 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility required

  • Case management and discharge planning experience preferred

  • Managed care/utilization review experience preferred


  • The minimum level of education required for candidates in this position is a Bachelor's degree or equivalent experience

Licenses or Certifications:

  • Licensed Social Worker (LCSW) is with active state license in good standing required


  • Functional - Medical Management/Medical Management - Case Management/1+ Years

  • Functional - Clinical / Medical/Concurrent review / discharge planning/1+ Years


  • Technical - Desktop Tools/Microsoft Word/1+ Years/End User

  • Technical - Desktop Tools/Microsoft Outlook/1+ Years/End User


  • Benefits Management/Interacting with Medical Professionals/3+ years/ADVANCED

  • Benefits Management/Understanding Clinical Impacts/3+ years/ADVANCED

  • Leadership/Collaborating for Results/5+ years/MASTERY

Telework Specifications:

  • Current Aetna telework Social Workers are eligible to apply. External hires will be required to work in the office for a minimum of 12-18 months. Telework may be considered after that time, based on business unit needs.


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 candidate'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