Care Plan Reviewer

Job not on LinkedIn

🔥 17 hours ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Review member assessments and Child and Family-Centered Care Plans • Review crisis and safety plans for members experiencing behavioral health needs • Apply clinical judgment to reduce risk factors and address complex clinical indicators • Apply clinical criteria, guidelines, policies, procedures, and regulatory standards when completing reviews and prior approvals • Consult with supervisors, Medical Directors, and other programs to overcome care barriers • 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 • Coach care coordination staff and supervisors using motivational interviewing skills • Provide information and support to empower members toward independent medical and healthy lifestyle choices • Analyze utilization, self-report, and clinical data to identify comprehensive member needs • Support behavioral healthcare for children with serious or complex needs through coordinated OhioRISE services

🎯 Requirements

• Unencumbered Behavioral Health clinical license in Ohio required (LMFT, LSW, LPC) • 2+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a human services or behavioral health care field, providing community-based services to children and youth and their family/caregivers • Experience in family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development • 1+ year of experience with personal computers, keyboard, multi-systems navigation, and MS Office Suite applications • Willing and able to travel in-state up to 10% of the time with a personal vehicle • Minimum of a Master's degree in Counseling, Social Work, or Marriage and Family Therapy required • LPCC, IMFT, or LISW licenses preferred • 3+ years of direct clinical practice experience post-Master's degree 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 in addition to base pay