Clinical Care Plan Navigator – Behavioral Health

4004 Aetna Medicaid Administrators; Kentucky; Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Job summary

CVS Health is seeking a Care Plan Reviewer (Clinical Case Manager BH) to assess members, plan care, and coordinate with providers across medical and behavioral health services. This role emphasizes crisis intervention, holistic care planning, and collaboration with medical directors to optimize outcomes.

The position requires an Ohio license in behavioral health, 3+ years of post-Master's clinical practice, and travel up to 10%.

Qualifications

• Must be Ohio resident.
• Active Behavioral Health license in Ohio (e.g., LMFT, LSW, LPC, LISW).
• 3+ years of direct clinical practice post-Master's degree (hospital or ambulatory).
• 2+ years in children's mental health or related human services fields.
• 2+ years in case management, family counseling/therapy, or child development.
• Willing to travel up to 10% for regional trainings in OH; Columbus, OH travel expected.
• Mon-Fri, 8am-5pm working hours.
• 1+ year experience with MS Office and multi-system navigation.

Responsibilities

• Conduct comprehensive assessments of member needs and eligibility using clinical tools.
• Apply clinical judgment to care planning and provider coordination; crisis intervention as needed.
• Consult with supervisors/ Medical Directors to overcome barriers and ensure appropriate care.
• Develop and monitor plans of care with the member and care team; ensure regulatory compliance.
• Coordinate with care teams and utilize case management processes for quality care.

Skills

Clinical judgment

Crisis intervention

Communication

Education

Master's degree in Counseling, Social Work, or Marriage and Family Therapy

Tools

MS Office

Job description

CVS Health is seeking a Care Plan Reviewer (Clinical Case Manager BH) to assess members, plan care, and coordinate with providers across medical and behavioral health services. This role emphasizes crisis intervention, holistic care planning, and collaboration with medical directors to optimize outcomes.

The position requires an Ohio license in behavioral health, 3+ years of post-Master's clinical practice, and travel up to 10%.