Clinical Case Manager, Behavioral Health

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🔥 0 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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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

• Conduct comprehensive assessments of referred members’ needs and eligibility • Develop case-resolution approaches using benefit plans and internal and external programs/services • 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 and provide crisis follow-up • Apply clinical criteria, guidelines, case management plans, policies, procedures, and regulatory standards • Consult with supervisors, Medical Directors, and other programs to overcome barriers • Present cases at conferences to obtain multidisciplinary input • Identify and escalate quality-of-care issues • Communicate with medical and behavioral health professionals to influence appropriate care • Use motivational interviewing to engage members and promote lifestyle or behavior changes • Provide coaching, information, and support for independent health decisions • Help members participate knowledgeably in healthcare decision-making • Analyze utilization, self-report, 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 requirements • Conduct face-to-face visits and in-person outreach through required in-state travel

🎯 Requirements

• Must reside in Louisiana • Must have reliable transportation • Ability to travel in-state up to 50% of the time • Unencumbered Independent Behavioral Health Clinical license in Louisiana (e.g., LCSW, LPC, LMFT) • 3+ years of direct clinical practice experience post master’s degree with general youth or pediatrics population in a hospital, ambulatory care, residential, or outpatient clinic/facility setting • 2+ years of experience with personal computers, keyboards, multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint, etc.) • Master’s degree required / specialized training / relevant professional qualification • Certified Case Manager (ACM) preferred • Crisis Intervention skills preferred • Child Welfare and/or Juvenile Justice experience preferred • Managed care/utilization review experience preferred • Case management and discharge planning experience preferred • Effective verbal and written communication skills • Ability to multitask, prioritize, and adapt to a fast-paced changing environment

🏖️ Benefits

• Flexible work schedule may be available after 6 months of service with demonstrated performance and attendance • 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 in addition to base pay