Clinical Case Manager Behavioral Health - Monmouth County

Hispanic Alliance for Career Enhancement; Middletown (NJ); Hybrid; USD 72,000 - 156,000; Full time

Job summary

An established industry player is seeking a passionate Clinical Case Manager to enhance healthcare delivery in New Jersey. This role focuses on developing and implementing health service strategies while collaborating with care teams to ensure quality care for members. With a flexible work-from-home arrangement and significant travel, the position offers a dynamic work environment. If you possess a Master's degree in Behavioral Health and have experience in case management, this opportunity could be your next career move. Join a team dedicated to making a meaningful impact in the lives of others.

Benefits

Comprehensive medical benefits

401(k) plan

Stock purchase options

Wellness programs

Flexible schedules

Qualifications

• 2+ years of Behavioral Health experience required.
• Completion of NJ Choice Certification is mandatory.

Responsibilities

• Conduct face-to-face assessments for members in the MLTSS program.
• Develop care plans and coordinate services for members.

Skills

Clinical Judgment

Critical Thinking

Assessment Skills

Communication Skills

Problem-Solving Skills

Education

Master's Degree in Behavioral Health

Tools

Electronic Health Records

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 more connected, more convenient, and more compassionate. 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 NJ Choice Certification.

This is a work-from-home flexible position with up to 75% travel throughout Monmouth, Ocean, and surrounding counties, New Jersey.

Standard working hours: Monday - Friday, 8 am - 5 pm EST.

Job Description

Develop, implement, support, and promote health service strategies, policies, and programs that drive the delivery of quality healthcare to our members. These include utilization management, quality management, network management, clinical coverage, and policies. The role requires advanced clinical judgment and critical thinking skills to facilitate appropriate physical, behavioral health, and psychosocial wrap-around services. Responsibilities include care planning, provider collaboration, and resource utilization in a cost-effective manner. Strong assessment, writing, and communication skills are essential.

Fundamental Components/Job Description

The Clinical Case Manager BH conducts face-to-face assessments of members enrolled in the Managed Long-Term Services and Supports (MLTSS) program and/or Dual Special Needs Program (D-SNP/FIDE). The role involves evaluating medical needs, facilitating wellness, and coordinating services such as adult and pediatric medical daycare, personal care assistance, nursing facility requests, and community resources. Completion of NJ Choice Certification is a requirement. The care manager collaborates with members, families, providers, and care teams, develops care plans, and documents accurately in electronic health records. The position requires critical thinking and problem-solving skills. While primarily telework, the care manager works normal business hours and may mentor new hires after proficiency is attained. Travel of 50-75% in Monmouth, Ocean, and surrounding counties is expected.

Required Qualifications

• Must reside in Monmouth County
• Willing and able to travel up to 75% in Monmouth, Ocean, and surrounding counties
• Reliable transportation (mileage reimbursed)
• Licensed Clinical Social Worker or Licensed Social Worker in NJ
• 2+ years of Behavioral Health experience
• Successful completion of NJ Choice certification (exam score of 80% or higher, plus training and mentoring)

Preferred Qualifications

• Case management/discharge planning experience
• Managed Care experience
• Crisis intervention skills
• LTSS experience
• Geriatric case management background

Education

• Master's Degree in a Behavioral Health field required

Additional Details

Anticipated weekly hours: 40

Time type: Full-time

Pay range: $72,627 - $155,538, with potential bonuses and incentives.

Benefits

Comprehensive benefits including medical, 401(k), stock purchase, wellness programs, time off, flexible schedules, and more. For details, visit CVS Benefits.

Application Deadline

Expected closing date: 05/02/2025.

Additional Information

CVS Health considers applicants with arrest or conviction records and requires certain colleagues to be vaccinated against COVID-19 unless approved for reasonable accommodation. We are committed to inclusion and equal opportunity employment.