Clinical Case Manager, Behavioral Health

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🗽 New York – Remote

🗽 New York – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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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 psychosocial, behavioral health, and care management assessments • Develop, implement, monitor, and update individualized care plans • Coordinate behavioral health, medical, pharmacy, and social support services across providers and settings • Identify and address barriers to care, including housing instability, food insecurity, transportation needs, and lack of social support • Facilitate referrals and linkage to community resources, behavioral health services, HCBS programs, and supportive services • Monitor member progress through outreach, care plan reviews, and interdisciplinary case discussions • Coordinate transitions of care following hospitalizations, psychiatric admissions, skilled nursing facility stays, emergency department visits, and rehabilitation services • Provide crisis intervention support and facilitate behavioral health referrals • Promote recovery-oriented, trauma-informed, and culturally competent care • Collaborate with psychiatrists, therapists, primary care providers, care management teams, and community partners • Educate members and caregivers regarding treatment plans, medication compliance, self-management, and available resources • Identify gaps in care and implement interventions to improve member outcomes and quality metrics • Participate in interdisciplinary team meetings, utilization reviews, and case conferences • Maintain timely and accurate documentation in compliance with organizational, state, federal, Medicaid, Medicare, and accreditation requirements • Complete required assessments, care plans, outreach activities, and regulatory documentation within established timeframes • Manage a caseload of members with varying levels of behavioral and medical complexity

🎯 Requirements

• Must be licensed in New York as LMSW or LCSW • Work schedule: Monday–Friday, 08:30 AM–05:00 PM EST • Minimum 3 years of experience in behavioral health, care management, case management, social work, managed care, health home, or related healthcare setting • Experience working with adults with serious mental illness, substance use disorders, and co-occurring behavioral and physical health conditions • Experience working with Medicaid and/or Medicare populations required • Experience coordinating services across behavioral health, medical, long-term care, and community-based settings • Master's Degree in Social Work (MSW) from an accredited institution required • Current New York State Licensed Master Social Worker (LMSW) required • Strong understanding of behavioral health diagnoses, treatment modalities, and recovery principles • Knowledge of Medicaid, Medicare, Managed Care, and behavioral health regulations • Knowledge of serious mental illness, substance use disorders, crisis intervention, and trauma-informed care • Excellent assessment, care coordination, and care planning skills • Strong clinical judgment and critical-thinking abilities • Ability to effectively engage members with complex psychosocial and behavioral health needs • Excellent communication, motivational interviewing, and relationship-building skills • Ability to work independently and manage a high-volume caseload • Proficiency with electronic medical records and care management platforms • Strong organizational skills and attention to detail

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to the base pay range • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility