Behavioral Health Clinical Case Manager – LCPC/LCSW

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🕒 5 dias atrás

🌽 Illinois – Remoto

🌽 Illinois – Remote

💵 $66.575 - $142.576 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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CVS Health

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1963

🏥 Saúde

⚕️ Seguro de Saúde

🛒 Varejo

Healthcare • Healthcare Insurance • Retail

CVS Health é uma empresa líder de saúde nos Estados Unidos, dedicada a ampliar o acesso e a acessibilidade ao cuidado. A empresa adota uma abordagem abrangente que inclui serviços de saúde, seguro saúde e gestão de benefícios farmacêuticos (PBM). Por meio de suas subsidiárias, como Aetna e CVS Caremark, a CVS Health oferece uma variedade de serviços que promovem o bem-estar, a gestão de condições de saúde e a cobertura acessível de medicamentos prescritos. A CVS Health opera farmácias de bairro, oferece serviços de farmácia por correspondência e gerencia programas de medicamentos de especialidade, com o objetivo de tornar o cuidado com a saúde conveniente e acessível para todos. Movida pela missão de conectar pessoas a serviços essenciais de cuidado, a CVS Health está comprometida em fomentar comunidades mais saudáveis e apoiar o bem-estar de todas as pessoas.

Descrição

• Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs for Aetna • Facilitate appropriate member physical health and behavioral healthcare through assessment and care planning • Coordinate and collaborate directly with providers • Coordinate psychosocial wraparound services • Conduct comprehensive assessments of referred members’ needs and eligibility • Evaluate benefit plans and internal and external programs/services to determine case resolution approaches • Apply clinical judgment to reduce risk factors and address complex clinical indicators • Perform crisis intervention for members experiencing behavioral health or medical crises • Refer members to appropriate clinical providers for assessment and treatment • Provide crisis follow-up to ensure members receive appropriate treatment and services • Apply and interpret clinical criteria, guidelines, standardized case management plans, policies, procedures, and regulatory standards • Consult with supervisors, Medical Directors, and other programs to overcome barriers to care goals • Present cases at multidisciplinary case conferences • Identify and escalate quality-of-care issues through established channels • Communicate with medical and behavioral health professionals to influence appropriate member care • Use motivational interviewing to engage members and promote lifestyle and behavior changes • Coach and empower members to make independent medical and healthy lifestyle choices • Help members participate knowledgeably in healthcare decision-making with providers • Analyze utilization, self-report, and clinical data to identify comprehensive member needs • Develop and monitor plans of care collaboratively with members and care teams • Use case management and quality management processes in compliance with regulatory, accreditation, and company requirements

🎯 Requisitos

• Must reside in Illinois • Reliable transportation and willingness and ability to travel up to 25% of the time in and around the candidate’s home location • Active and unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) license in Illinois • 3–5 years of direct clinical practice experience post master’s degree, such as in a hospital, ambulatory care, or outpatient clinic/facility setting • Master’s Degree in Behavioral/Mental Health or related field (required) • Confidence working at home and independently using virtual collaboration tools • Excellent analytical and problem-solving skills • Effective communication, organizational, and interpersonal skills • Ability to work independently • Effective computer skills, including navigating multiple systems and keyboarding • Proficiency with MS Word, Excel, Outlook, PowerPoint, and proprietary applications • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private, designated home virtual work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide own workspace furniture • Ability to use multiple monitors and navigate multiple applications simultaneously • Ability to use digital communication channels including email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer and password security practices and identify suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills as the workplace evolves • Preferred: case management and discharge planning experience • Preferred: managed care/utilization review experience • Preferred: crisis intervention skills

🏖️ Benefícios

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Mileage reimbursement according to company expense reimbursement policy • Company-provided equipment including keyboard, monitor, computer, and headset • Remote work from home • Comprehensive benefits package for full-time employees