Clinical Case Manager, Behavioral Health SNP

Job not on LinkedIn

🔥 4 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Conduct comprehensive assessments of referred members’ needs and eligibility using clinical tools and information/data review • Determine case resolution approaches and evaluate benefit plans and internal/external programs and services • Apply clinical judgment to reduce risk factors and address complex clinical indicators affecting care planning • Perform crisis intervention for members experiencing behavioral health or medical crises • Refer members to appropriate clinical providers and provide crisis follow-up • Apply and interpret clinical criteria, guidelines, 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 • Communicate with medical and behavioral health professionals to influence appropriate member care • Use motivational interviewing to engage members and promote lifestyle and behavior changes • Provide coaching, information, and support for independent medical and healthy lifestyle choices • Help members participate knowledgeably in healthcare decision-making with providers • Analyze utilization, self-reported, and clinical data to identify comprehensive member needs • Develop and monitor plans of care with members and care teams • Use case management and quality management processes in compliance with regulatory, accreditation, and company guidelines

🎯 Requirements

• 3+ years of direct clinical practice experience post master's degree, such as in a hospital, ambulatory care, or outpatient clinic/facility setting • 3+ years of knowledge of mental health and substance abuse disorders • 3+ years of experience talking, speaking on the telephone, and typing at the same time • 3+ years of experience using Motivational Interviewing and good technological skills • Valid unrestricted independent professional behavioral health clinical license to practice under state regulations in the state of residence; examples include LCSW, LSW, LISW, LCPC, LP, LMFT, or LMHC • Master's Degree in Social Work or Counseling required • Crisis intervention skills preferred • Managed care/utilization review experience preferred • Case management and discharge planning experience preferred

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility

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