Standard business hours Monday-Friday. No nights, no weekends, no holidays and no oncall.

Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes.

• Telephonic clinical case management with Medicare population.
• Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs.
• Completes a Comprehensive Assessment and Plan of care.
• Will document in clinical systems to support legacy Aetna and Coventry membership.
• Provides BH consultation and collaboration with Aetna partners.
• Active participation in clinical treatment rounds.
• Active participation in team activities focused on program development. Innovative thinking expected.
• The majority of time is spent at a desk on telephonic member outreaches and computer documentation.
• Assist members with locating community based behavioral health resources.

Required Qualifications

- 3+ years of direct clinical practice experience
- An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC, LISW, LSW)
- Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service

Preferred Qualifications

- Crisis intervention skills preferred
- Managed care/utilization review experience preferred
- Case management and discharge planning experience preferred

Discharge planning experience
- Utilization review, prior authorization, concurrent review, appeals experience

- CCM preferred
- DSNP experience a plus

Education

Masters Degree in Social Work or Counseling required

Pay Range

The typical pay range for this role is:

$54,095.60 - $129,615.20

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/01/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.