Behavioral Health Care Plan Manager

CVS Health Corporation; Kentucky; Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a Care Plan Reviewer (Clinical Case Manager BH) to assess and coordinate physical and behavioral health services for members in Ohio. You will use clinical judgment to create care plans, coordinate providers, and support psychosocial wraparound services across child-serving systems.

Responsibilities include conducting comprehensive assessments, applying guidelines, crisis intervention, care coordination, and monitoring plans with the care team.

Qualifications

• Must be Ohio resident.
• Active Behavioral Health license in Ohio (LMFT, LSW, LPC, LISW).
• 3+ years direct clinical practice post-Master's degree.
• 2+ years in children's mental health or related field.
• 2+ years in family systems, case management or related areas.
• Willing to travel up to 10% for OH trainings.
• Willing to work 8am-5pm, Monday–Friday.
• 1+ year experience with MS Office.

Responsibilities

• Conduct comprehensive assessments of referred members’ needs and eligibility.
• Apply clinical judgment to care planning and benefits administration.
• Perform crisis intervention and refer to appropriate providers.
• Provide crisis follow up to ensure suitable treatment.
• Consult with supervisors and Medical Directors to address barriers.
• Identify and escalate quality of care issues.
• Influence member care through motivational interviewing.
• Provide coaching to empower independent health decisions.
• Assist members in healthcare decision-making.
• Analyze utilization and data to identify needs.
• Develop and monitor plans of care with the care team.
• Utilize case management and quality processes per regs.

Skills

Clinical judgment

Crisis intervention

Care coordination

MS Office

Travel up to 10%

Communication

Assessments

Behavioral health

Education

Master's in Counseling, Social Work, or MFT

Tools

MS Office Suite

Case management systems

Job description

CVS Health is seeking a Care Plan Reviewer (Clinical Case Manager BH) to assess and coordinate physical and behavioral health services for members in Ohio. You will use clinical judgment to create care plans, coordinate providers, and support psychosocial wraparound services across child-serving systems.

Responsibilities include conducting comprehensive assessments, applying guidelines, crisis intervention, care coordination, and monitoring plans with the care team.