Clinical Case Manager, Behavioral Health
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Job Description
CVS Health behavioral health case manager coordinating assessments, care plans, providers, and crisis intervention. Supporting members remotely through clinical judgment, coaching, and resource coordination.
Responsibilities:
- Facilitate appropriate member physical health and behavioral healthcare through assessment and care planning
- Coordinate directly with providers and collaborate with care teams
- Coordinate psychosocial wraparound services and available resources
- Conduct comprehensive assessments of referred members’ needs, eligibility, benefits, and services
- Apply clinical judgment and strategies to reduce risk factors and address complex clinical indicators
- Perform crisis intervention and provide crisis follow-up
- Apply clinical criteria, guidelines, case management plans, policies, procedures, and regulatory standards
- Consult with supervisors, Medical Directors, and other programs; present cases at case conferences
- Identify and escalate quality-of-care issues
- Use motivational interviewing to promote member engagement and healthy behavior changes
- Provide coaching, information, and support for independent healthcare decisions
- Analyze utilization, self-report, and clinical data to identify comprehensive member needs
- Develop and monitor plans of care with members and care teams
- Manage case management and quality management processes in compliance with regulatory and accreditation guidelines
- Take and manage crisis calls
Requirements:
- Unencumbered independent behavioral health clinical license in the state where they reside and work: LMHC, LCSW, LISW, LMFT, or LPC
- 3+ years of direct clinical practice experience post masters degree
- 3+ years minimum of Behavioral Health experience
- Willingness to work standard business hours in EST or CST
- Case management and discharge planning experience preferred
- Crisis intervention skills preferred
- Managed care/utilization review experience preferred
- Ability to take and manage crisis calls
- Minimum of a Master’s degree in Behavioral/Mental Health or related field
Benefits:
- CVS Health bonus, commission or short-term incentive program in addition to the base pay range
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
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