Clinical Case Manager Behavioral Health

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.

This purpose guides our commitment to deliver enhanced human-centric health care 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. 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 health care more personal, convenient and affordable.

Position Summary

This is a remote position that requires 50-75% travel in Cook County / Chicago, IL and surrounding areas to meet with members face to face.

Must have reliable transportation).

This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members.

This position is critical to meet contractual requirements.

Facilitate appropriate healthcare outcomes for LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.

Evaluation of Members :

Through the use of care management tools and information / data review, conducts comprehensive evaluation of referred members' needs / eligibility and recommends an approach to case resolution and / or meeting needs by evaluating members' benefit plan and available internal aid and external programs / services.

Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.

Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care

Using holistic approach consults with case managers, supervisors, Medical Directors and / or other health programs to overcome barriers to meeting goals and objectives;

presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.

Identifies and escalates quality of care issues through established channels.

Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and / or healthcare needs.

Utilizes influencing / motivational interviewing skills to ensure maximum member engagement and promote lifestyle / behavior changes to achieve optimum level of health.

Provides coaching, information and support to empower the member to make ongoing independent medical and / or healthy lifestyle choices.

Helps member actively and knowledgeably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care :

Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications

• Minimum of 2 years of experience in behavioral health or social services field
• Willing and able to travel up to 50-75% of their time to meet with members face to face in Cook County / Chicago, IL and surrounding areas
• Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy
• Active IL BH clinical license LCSW, LCPC, LMFT

Preferred Qualifications

• Case Management and Discharge Planning
• Managed Care experience
• Microsoft Office experience

Education

Masters degree required, with either degree being in behavioral health, social services or human services field.

Pay Range

The typical pay range for this role is :

$29.50 - $132,600.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.