Clinical Case Manager Behavioral Health - Monmouth and Ocean Counties

Hispanic Alliance for Career Enhancement; Toms River (NJ); On-site; USD 72,000 - 156,000; Full time

Job summary

An established industry player is seeking a dedicated Clinical Case Manager to enhance healthcare delivery. In this role, you will develop and implement health service strategies, ensuring quality care for members. Your expertise in behavioral health and strong communication skills will be crucial as you collaborate with care teams and advocate for members' needs. This position offers a competitive salary, signing bonus potential, and a comprehensive benefits package, making it an exciting opportunity for passionate professionals looking to make a difference in the community.

Benefits

401(k) plan with company matching

Affordable medical plan options

Employee stock purchase plan

Wellness screenings

Tuition assistance

Flexible work schedules

Paid time off

Family leave

Colleague assistance programs

Qualifications

• 2+ years of behavioral health experience required.
• Licensed Clinical Social Worker or Licensed Social Worker in NJ.

Responsibilities

• Conduct face-to-face visits and comprehensive assessments of members.
• Coordinate care with members and authorized representatives.

Skills

Behavioral Health Experience

Clinical Judgment

Communication Skills

Critical Thinking

Assessment Skills

Education

Master's Degree in Social Work

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

Signing bonus potential up to $10,000 for eligible external candidates who possess valid/current NJ Choice Certification

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services. The care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. Strong assessment, writing and communication skills are required.

Fundamental Components/Job Description:

The Clinical Case Manager BH is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Care manager may also be responsible for face to face assessments with non-MLTSS members to evaluate the medical needs of the member to facilitate the member's overall wellness and help them obtain the services they need to thrive by addressing requests for services such as adult medical daycare, pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment. Successful completion of company sponsored NJ Choice Certification is requirement for continued employment. The care manager is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant. The care manager will attend interdisciplinary meetings and advocate on members behalf. The care manager works with member and care team to develop care plan and will authorize services within the MLTSS/ FIDE benefit. The care manager will also work with the member and care team to coordinate and assist with community resources. The care manager is responsible for documenting accurately and timely in the electronic health record. This position requires the care manager to use critical thinking and be able to problem solve any issues related to assigned membership. While this position is tele-work the care manager must work normal business hours. The Case Manager will also be expected, to mentor new hires, once, a level of proficiency has been attained in their role. 50 to 75% travel in Monmouth/Ocean and surrounding counties.

Required Qualifications

• Licensed Clinical Social Worker or Licensed Social Worker in NJ
• 2+ years behavioral health experience/expertise
• 50 to 75% travel in Monmouth/Ocean County and surrounding counties
• Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.

Preferred Qualifications

• Candidates residing in Toms River, Brick, Whitesville, or Jackson
• Case management and/or discharge planning experience
• Managed Care experience
• Crisis intervention skills

Education

• Master's Degree in Social Work or Behavioral Health field required

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$72,627.00 - $155,538.00

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: 05/09/2025

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

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [e-mail] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.