Standard business hours Monday- Friday with flexibility needed to work between 5pm to meet member needs.

The Clinical Care Manager BH is responsible for care coordination and case management for members, up to age 20, who have experienced a crisis event and coordinates all case management activities with members to evaluate physical and behavioral health needs and to facilitate the overall wellness of members. Develops strategy to address issues to outcomes and opportunities to enhance member's overall wellness through integration. Instructs programs and procedures in compliance with network management and clinical coverage policies.

Essential Duties and Responsibilities

Executes evaluation of member needs and benefit plan eligibility and facilitates member transition to the organization's programs and plans; Applies advanced clinical judgement to incorporate strategies designed to reduce risk factors and barriers, and to address complex health indicators that impact care planning and resolution of member issues; Handles reviews of prior claims to address potential impact on current case management and eligibility; Creates a holistic approach to assess the need for referrals to clinical resources and to assist in determining functionality; Ensures case management processes follow organization and regulatory requirements; Implements systems to maximize member engagement, discern health status and needs, and to assess member levels of work capacity and restrictions; Coaches and trains junior colleagues in techniques, processes, and responsibilities.

For this role you will need Minimum Requirements:

Basic awareness of problem solving and decision making skills

Required Qualifications

- Active, unrestricted LCSW, LCPC, or LMFT in the state of Illinois

- Minimum two years experience working with children

- Willing and able to travel up to 50-75% of their time to meet members face to face within one hour of their location.

- Reliable transportation required ; mileage is reimbursed per company expense reimbursement policy.

Preferred Qualifications
-Previous care management experience
-Experience working with children who have special needs or children in foster care.

Education Minimum requirement of Masters degree in Counseling or Social Work

Pay Range

The typical pay range for this role is:

$66,575.08 - $142,576.72

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: 12/31/2024

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

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.