Behavioral Health Care Planner

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Support clinical teams to enhance the quality and coordination of member care • Prepare administrative and medical-necessity determination letters • Communicate medical review results to providers and utilization teams, including next steps • Schedule and coordinate appointments between providers and Aetna Medical Directors or Consultants • Gather documentation for clinical appointments • Track deadlines to ensure timely completion • Ensure compliance with state requirements and Aetna policies • Collaborate with Medical Directors, clinicians, and customer service teams on higher-level case reviews

🎯 Requirements

• 2+ years of experience in health insurance, administrative/secretarial work, or customer service within a healthcare or mental health environment • Ability to type 60–70 words per minute • Proficiency with Microsoft Office Suite, including Outlook, Word, and Excel • Strong organizational and time-management abilities • Excellent written and verbal communication skills • Understanding of commercial insurance products • Understanding of mental health and substance abuse-related levels of care • Strong attention to detail and problem-solving ability • Associate degree or equivalent experience, including healthcare industry experience • Availability Monday–Friday, 11:00 AM–7:30 PM EST; some company holiday and weekend coverage may be required

🏖️ Benefits

• 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