Clinical Case Manager Behavioral Health

CVS Health; Union (NJ); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare provider is seeking a Clinical Case Manager Behavioral Health to develop and implement health service strategies. This role involves care planning, direct provider collaboration, and effective utilization of resources. The position requires strong assessment and communication skills, with a significant travel component in Union and surrounding counties.

Qualifications

• Strong assessment, writing, and communication skills are essential.
• Advanced clinical judgment and critical thinking skills required.

Responsibilities

• Conduct face-to-face assessments with members enrolled in MLTSS and/or D-SNP.
• Coordinate care with members, PCPs, and care teams.
• Document accurately in electronic health records.

Skills

Assessment

Communication

Critical Thinking

Job description

Join to apply for the Clinical Case Manager Behavioral Health role at CVS Health.

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. These include utilization management, quality management, network management, and clinical coverage policies. The position requires advanced clinical judgment and critical thinking skills to facilitate appropriate physical, behavioral health, and psychosocial wrap-around services.

The care manager will be responsible for care planning, direct provider collaboration, and effective utilization of resources in a cost-effective manner. Strong assessment, writing, and communication skills are essential. Responsibilities include conducting face-to-face assessments with members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE), evaluating medical needs, and facilitating overall wellness.

The role involves coordinating care with members, authorized representatives, PCPs, and care teams, attending interdisciplinary meetings, advocating for members, developing care plans, and authorizing services within the MLTSS/FIDE benefits. The care manager will also coordinate community resources, document accurately in electronic health records, and problem-solve issues related to assigned memberships.

This tele-work position requires working normal business hours, with 50-75% travel in Union and surrounding counties. Mentoring new hires is expected once proficiency is attained.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: Hospitals and Health Care