Clinical Case Manager Behavioral Health

ester, Norfolk, Virginia Beach, Hampton, Northampton, Williamsburg, Isle Of Wight, Poquoson, York) OR Northern & Winchester Region (counties include Alexandria, Falls Church, Page, Arlington, Fauquier, Prince William, Clarke, Frederick, Rappahannock, Culpeper, Loudoun, Shenandoah, Fairfax City, Manassas City, Warren, Fairfax Co., Manassas Park, Winchester) OR Charlottesville/Western Region (counties include Albemarle, Danville, Nelson, Amherst, Fluvanna, Orange, Appomattox, Greene, Pittsylvania, Augusta, Halifax, Rockingham, Buckingham, Harrisonburg, Staunton, Campbell, Louisa, Waynesboro, Charlotte, Lynchburg, Charlottesville, Madison).

The schedule is Monday-Friday, standard business hours. Must possess reliable transportation and be willing and able to travel in the assigned region 25-40% of the time.

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.

• Monitor clinical care services provided to members related to mental health and substance abuse treatment to optimize clinical outcomes.
• Provide telephone triage and crisis intervention.
• Provide information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Aetna Behavioral Health policies and procedures, and criteria.
• Interact with Supervisors to discuss clinical questions and concerns regarding specific cases.
• Participate in QI activities including data collection, tracking, and analysis. Telephonic clinical case management.
• 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.
• Active participation in clinical treatment rounds.
• Active participation in team activities focused on program development. Innovative thinking expected.

Required Qualifications:

• 2+ years of direct clinical practice experience post degree e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility required.

• One of the following licenses for Virginia is required: LPC, LCSW, LMFT, LBA

• Must possess reliable transportation and be willing and able to travel in Virginia, 25-40% of the time.

Preferred Qualifications:

• 2+ years of managed care experience.
• Discharge planning experience preferred.
• Utilization review, prior authorization, concurrent review, appeals experience preferred.
• Advanced crisis intervention skills preferred.
• CCM preferred.

Education

A minimum of a Master's Degree

Pay Range

The typical pay range for this role is:

$60,522.80 - $129,600.00

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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 09/30/2024

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