Clinical Case Manager Behavioral Health

New Jersey Psychological Association; Sacramento (CA); Remote; USD 54,000 - 143,000; Full time

Job summary

A leading health solutions company is seeking professionals to join a behavioral healthcare team in a remote setting. The role involves conducting assessments, crisis intervention, and developing care plans to support member health outcomes. Applicants must have a Master’s degree and a clinical license, alongside experience in behavioral health care, to help empower members in their healthcare decisions.

Benefits

Affordable medical plan options

401(k) plan with company matching

Employee stock purchase plan

Wellness screenings and confidential counseling

Flexible work schedules

Tuition assistance

Qualifications

• Unencumbered Independent Behavioral Health clinical license required.
• 3+ years of clinical practice experience post master's degree.
• 3+ years minimum of Behavioral Health experience.

Responsibilities

• Conduct comprehensive assessments of member's needs and eligibility.
• Provide crisis intervention and follow-up care to members.
• Develop and monitor care plans alongside members and their care team.

Skills

Crisis intervention

Case management

Coaching

Education

Master's degree in Behavioral/Mental Health

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary:

This role is work at home anywhere in the country.

Applicants must be willing to work standard business hours in CST or MST.

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.

Assessment of Members:

-Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.

-Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.

-Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated.

-Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services.

Enhancement of Medical Appropriateness and Quality of Care:

-Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits

-Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes

-Identifies and escalates quality of care issues through established channels

-Ability to speak to medical and behavioral health professionals to influence appropriate member care.

Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health

-Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

-Helps member actively and knowledgably participate with their provider in healthcare decision-making

-Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.

Monitoring, Evaluation and Documentation of Care

-In collaboration with the member and their care team develops and monitors established plans of care to meet the member's goals

-Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

- Ability to take and manage crisis calls.

Required Qualifications:

-Minimum of a Master's degree in Behavioral/Mental Health or related field

-Unencumbered Independent Behavioral Health clinical license in the state where they work:

Licensed Mental Health Counselor (LMHC)

Licensed Clinical Social Worker (LCSW)

Licensed Independent Social Worker (LISW)

Licensed Marital and Family Therapist (LMFT)

Licensed Master Social Worker (LMSW)

Licensed Professional Counselor (LPC)

Licensed Social Worker (LSW)

-3+ years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility

-3+ years minimum of Behavioral Health experience

Preferred Qualifications

-Crisis intervention skills preferred

-Managed care/utilization review experience preferred

-Case management and discharge planning experience preferred

- Ability to take and manage crisis calls.

Business Overview

Bring your heart to CVS Health

Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day.

CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $142,576.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/30/2025

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