Case Manager Jobs At CVS Health

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_ **_$17,500_** _for candidates who possess valid/current NJ Choice Certification or_ **_$7,500_** _for all other eligible external candidates._ This is a work from home flexible position with up to 75% travel requirements throughout Union and surrounding counties, New Jersey. Standard working hours Monday - Friday 8-5 pm EST. **** : 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 Union and surrounding counties. **Required Qualifications** + Must reside in **Union County** + Licensed Clinical Social Worker or Licensed Social Worker in NJ + 2+ years Behavioral Health experience + Must be willing and able to travel up to 75% in Union County and surrounding counties. + Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy + 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** + Case management and/or discharge planning experience + Managed Care experience + Crisis intervention skills + LTSS experience + Proficiency using computers, keyboards and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams, etc.) **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 ***************************************** We anticipate the application window for this opening will close on: 04/03/2025 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 ******************************** 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. We are an equal opportunity and affirmative action employer. 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.

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient support services in accordance with the program business rules and HIPAA regulations. This role involves care coordination, insurance verification and navigation, patient advocacy, program expertise, and continuous improvement efforts. This program will be working in the manufacturer's CRM system, and this role will require resiliency to change as we will be working in a system that is evolving. This position is responsible for guiding the healthcare providers through the various process steps in support of their patient's journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner. + Process enrollments via inbound fax, phone, and electronically. + Provide world-class service and receive inbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution. + Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate + Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program. + Assigned as point of contact for physician offices, patients, and FRM (Field Reimbursement Managers) for patients enrolled into the patient support program. + Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience. + Work with specialty pharmacies, insurance providers, and healthcare provider offices to help patients gain access to therapy. + Compliantly coordinate the exchange of patient-related information with internal and external stakeholders. + Conduct benefit verifications and collaborate with various healthcare providers, including physicians, pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services. + Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed. + Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes. + Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products + Actively advocate for patients' needs by navigating complex healthcare systems, addressing concerns with providers, and securing necessary approvals for treatments and medications. + Implement strategies to promote medication adherence, including patient education, regular check-ins, and addressing potential barriers to compliance. + Take ownership of intricate patient cases involving multiple medications, chronic conditions, or challenging adherence issues, developing personalized care plans, and monitoring progress closely + Evaluate patient eligibility for assistance programs and assist with enrollment when applicable. + Create and implement action plans to address patient access barriers and demonstrate accountability in execution, driving for success and results. + Remain updated on available patient resources and diligently oversee systems and procedures to maintain accuracy and efficiency. + Track key patient metrics, analyzing data to identify trends and areas for improvement, and generating reports for stakeholders. + Anticipate potential problems, refer to policies and past practices for guidance and develop and execute effective solutions. + Provide guidance and training to junior case managers on best practices in case management, patient interaction, and navigating internal and external systems. + Actively participate in initiatives to improve care delivery, streamline processes, and enhance patient experience within the patient support program. + Use root-cause analysis to investigate and resolve issues affecting patient access. + Build and maintain professional relationships with all internal and external stakeholders, including case management, patient support services, medical, sales, market access, insurance companies, specialty pharmacies, and office coordinators. + Proactively document and share reimbursement and other knowledge with patient support program team members through resources, consultation for complex cases, and special projects as requested. + Consistently maintain and document accurate data, including insurance, coverage approvals, on-going coverage requirements, and all patient and provider interactions. + Gain and sustain proficiency in use of the manufacturer's CRM tool to document work and progress the patient journey. Consistently leverage CRM reporting tools and data analytics to make strategic decisions while prioritizing patient and customer needs, while tracking and communicating areas within the CRM where refinement would be beneficial. + Provide caseload coverage outside of assigned territory as needed. + Ensure compliance with company and manufacturer policies. **_What is expected of you and others at this level_** + Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments + In-depth knowledge in technical or specialty area + Applies advanced skills to resolve complex problems independently + Works independently within established procedures; may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced team members **_Qualifications_** + High school diploma or GED preferred + Bachelor's degree in related field, or equivalent work experience in related field strongly preferred. + 5-8 years of industry experience with patient-facing or high touch customer interaction experience. + In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations. + Strong understanding of pharmaceutical therapies, disease states, and medication adherence challenges. + Ability to analyze complex situations, identify potential obstacles, and develop creative solutions to address patient needs + Significant experience in managing complex patient cases within a healthcare setting, preferably with a focus on specialty medications. + Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers. + Experience and demonstrated success working in a complex matrix to accomplish goals with a patient centric approach. + Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust. + Robust computer literacy skills including data entry and MS Office-based software programs. + Ability to identify and handle sensitive issues, working independently and collaboratively within teams. + Consistently demonstrates effective utilization and application of resources. + Ability to work independently, prioritize effectively, and thrive in a fast-paced, dynamic environment. + Demonstrates a high level of adaptability and openness to new ideas, with a proven ability to embrace change and thrive in dynamic environments. + Proficiency in managing data and analytics tools is a plus. + Bi-lingual; Spanish language skills preferred. **TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. **REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: + Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated hourly range:** $26.20 per hour - $33.66 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 05/15/2025 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster.** **Responsibilities** + Must demonstrate a superior willingness to help external and internal customers + First point of contact on inbound calls, and determines needs, and handles accordingly + Creates and completes accurate applications for enrollment with a sense of urgency + Scrutinizes forms and supporting documentation thoroughly for any missing information or new information to be added to the database + Conducts outbound correspondence when necessary to help support the needs of the patient and/or program + Conducts benefits investigations to identify patients' insurance plan coverage for medications, procedures, and travel and lodging + Provides detailed activity notes as to what appropriate action is needed for the Benefit Investigation processing + Assist with coordination of travel and lodging associated with patient therapy + Working alongside teammates to best support the needs of the patient population or transfer caller to appropriate team member (when applicable) + Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance + Update internal treatment plan statuses and external pharmacy treatment statuses + Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information + Notify patients, physicians, practitioners, and/or clinics of any financial responsibility of services provided as applicable + Responsible for placing all outbound calls to ensure the process is complete + Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance + Must follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted + Documentation must be clear and accurate and stored in the appropriate sections of the database + Must track any payer/plan issues and report any changes, updates, or trends to management + Ability to search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation + Handle all escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client + Responsible for reporting any payer issues to the appropriate team + Must self-audit activities to ensure accuracy and efficiency for the program **_Qualifications_** + Previous customer service experience, preferred + High School diploma or equivalent, preferred + Demonstrated high level customer service + Experience conducting and documenting patient medical health insurance benefit investigations, prior authorizations, and appeals, preferred + Cell/Gene therapy and/or Oncology experience, preferred + Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred + Important to have a strong attention to detail **_What is expected of you and others at this level_** + Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments + In-depth knowledge in technical or specialty area + Applies advanced skills to resolve complex problems independently + May modify process to resolve situations + Works independently within established procedures; may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced team members **TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CST, mandatory on camera attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 8:00am- 6:00pm CST. **REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated hourly range:** $21.50 per hour - $30.70 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 05/22/2025 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

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 Fully remote in USA. Shift: Monday-Friday standard business hours in time zone of residence No nights, no weekends, no holidays and no on call. The Clinical Case Manager 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. * The telephonic clinical case manager applies clinical judgment and incorporates the strategies designed to reduce risk factors for readmission and addresses complex clinical indicators which impact care planning and resolution of member issues. * Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs. * Using clinical tools and information/data review, conducts comprehensive assessments of member's needs and determines approach to case resolution and meeting needs by evaluating member's benefit plan and available internal and external programs and services with intent of reducing readmissions * Will document in healthcare clinical systems to support ACA Individual Family Plan population. * Provides BH consultation and collaboration with Aetna partners and other Shared Services with active participation in Interdisciplinary Care Team case conferences. * Active participation in team activities focused on program development. Innovative thinking expected. * This is a telephonic remote position, that is member-facing role with primary responsibility that includes member outreaches and computer documentation. * Assist members completing medication reconciliation, provider referrals for aftercare and locating community based behavioral health resources as well as locating resources for social determinants of health. Required Qualifications * 3+ years of direct clinical practice experience * Master's degree in behavioral health field with unrestricted license in state of residence (ex: LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist.), or active Compact RN license with extensive behavioral health background (BSN preferred) * 2+ year of experience with Microsoft Office applications (Outlook, Teams, Excel) * Must have dedicated work area established with high speed internet connection with ethernet hard line connection * Bilingual Spanish and English Preferred Qualifications * Crisis intervention skills * Managed care or utilization review experience * Case management and discharge planning experience * Substance Use Disorder experience * Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually * Education Master's Degree in Social Work or Counseling required OR RN with 3 years of behavioral health experience 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 ***************************************** We anticipate the application window for this opening will close on: 04/04/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. **Position Summary** My Care of Ohio hiring for care management in one of our counties we serve. The applicant must reside in Butler, Clermont, Hamilton, or Warren County in Ohio. We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Licensed Independent Social Worker to join our Case Management team. This opportunity offers a competitive salary and full benefits. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members. Case Manager BH is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Using clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in g functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. **Required Qualifications** - Active and good standing Licensed Independent Social Worker (LISW) for Ohio - 3+ years of behavioral health or social work experience - Must be willing and able to travel up to 50-75% of the time in Hamilton, Butler, Warren or Clermont County. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy. **Preferred Qualifications** - Case management experience - Community social work experience - Computer Skills (Microsoft office such as: Word, Excel, and outlook) **Education** - Masters degree in social work **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $116,760.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health (****************************************** We anticipate the application window for this opening will close on: 04/01/2025 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 ******************************** 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. We are an equal opportunity and affirmative action employer. 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.

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 is a non- member facing role with up to 30% travel requirements anywhere in the state of OH (Includes West, Central, South and Northeast regions) 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. Position Responsibilities: * 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. * 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. * 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 Required Qualifications * Minimum 3 years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility. * Active and unrestricted Independent Behavioral Health clinical license in the state of Ohio. ( Ex - LISW, LPCC, LCSW) * Must be resident of Ohio State. * Willing and able to travel up to 30% anywhere in the state of Ohio as needed. (staff meetings, Health Forums etc). * Eligible for mileage reimbursement and reliable transportation is required. Preferred Qualifications * Crisis intervention skills preferred. * Managed care/utilization review experience preferred. * Case management and discharge planning experience preferred * Experience working children and families, child serving systems * Working within a system of care to support care coordination * Working with multisystem Education * Masters degree in Behavioral Health/Social service or human services field required. Independently Licensed Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 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 ***************************************** We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. Work at home with requirement to reside in Illinois. Preference for those residing in Cook County or surrounding areas. Potential for up to 15% of travel for occasional face to face visits with members and travel to Downers Grove/Chicago office for meetings. Monday- Friday 8:00 am-5:00 pm. Utilizes advanced clinical judgement 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 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. Required Qualifications * Minimum of 2 years of direct clinical practice experience (e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility) * Must possess active and unrestricted Behavioral Health clinical license (LCSW or LCPC) in the state of Illinois. * Willing and able to travel to meet members face to face and for onsite meetings within Cook County IL and surrounding areas/counties (Chicagoland area) * Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy. * 2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) Preferred Qualifications * Crisis intervention skills preferred * Managed care/utilization review experience preferred * Case management and discharge planning experience preferred. Education Minimum of a master's degree required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. **Position Summary** The Behavioral Health Coordinator is a full time work from home position. This position is a primary point of contact to provide Plan-level leadership in working with behavioral health providers and other member-serving agencies involved to address barriers to crisis and other behavioral health care raised by members, family members and adoptive parents; working collaboratively with network managers to reduce out-of-state placements; referral assistance; and is actively involved in managing out-of-state placements. This position 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. Fundamental components: + 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. 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. + 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. **Required Qualifications** + Must reside in Arizona + Behavioral Health clinical license in the state of Arizona (eg., LCSW, LMSW, LPC, LAC, LMFT, LAMFT) + 3+ years of direct clinical practice experience post Master's degree, e.g., inpatient or outpatient behavioral health setting + 1+ years of experience working with and navigating Arizona DCS state welfare system, resources, and programs + 1+ years computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel + Ability to travel in state with a personal vehicle up to 10% of the time. Qualified candidates must have a valid AZ driver's license, reliable transportation, and proof of vehicle insurance **Preferred Qualifications** + Understanding and/or experience with higher levels of care including residential facilities, out of home behavioral health treatments, and inpatient hospitalization + Experience working with pediatric populations + Case management and discharge planning experience + Managed care experience **Education** + Minimum of a Master's degree in Behavioral/Mental Health or related field required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $60,522.00 - $129,615.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health (****************************************** We anticipate the application window for this opening will close on: 03/14/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

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. Fully remote role with requirement to hold an active Illinois LCSW or LCPC license. Must reside in Illinois, Wisconsin, Iowa, Missouri, or Indiana and within 3 hour driving time to Chicago or Downer's Grove offices. Potential for quarterly meetings in Chicago/Downer's Grove area. Position Summary The Clinical Case Manager, Behavioral Health, is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CCM, BH, 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 wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. Position Responsibilities: * Responsible for telephonic assessment, planning, implementing and coordinating care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. * Develops a proactive course of action to address issues presented and facilitate short and long-term outcomes as well as identify opportunities to enhance a member's overall health through integration. * Through the use of clinical tools and information/data review, conducts comprehensive assessments of member's needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services. * Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical and social indicators which impact care planning and resolution of member issues. * Completes assessments that take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality and the member's restrictions/limitations. * Analyzes utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. * Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health 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 and services. * Applies and interprets 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. * Serves as a single point of contact for members and assists members to remediate immediate and acute gaps in care and access. * Using holistic approach consults with managers, medical directors and/or other physical/behavioral health support staff and providers to overcome barriers to meeting goals and objectives/ * Presents cases at case conferences/rounds to obtain multidisciplinary view in order to achieve optimal outcomes. * Works collaboratively with the members' interdisciplinary care team. * 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 discern their health status and health needs based on key questions and conversation. * 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. * 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. * Facilitates clinical hand offs during transitions of care. Required Qualifications * - 3+ years of direct clinical practice experience post Clinical Licensure ( LCSW or LCPC), e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility * 5+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) * 2+ years of crisis intervention skills * Illinois-licensed Licensed Clinical Social Worker (LCSW) or LCPC ( Licensed Clinical Professional Counselor with current unencumbered license required Preferred Qualifications * Case management and discharge planning experience strongly preferred Education * Masters Degree. * Illinois Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor ( LCPC) with current unencumbered license required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $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 ***************************************** We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. Work at home with requirement to reside in Illinois. Preference for those residing in Cook County or surrounding areas. Potential for up to 15% of travel for occasional face to face visits with members and travel to Downers Grove/Chicago office for meetings. Monday- Friday 8:00 am-5:00 pm. Utilizes advanced clinical judgement 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 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. Required Qualifications * Minimum of 2 years of direct clinical practice experience (e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility) * Must possess active and unrestricted Behavioral Health clinical license (LCSW or LCPC) in the state of Illinois. * Willing and able to travel to meet members face to face and for onsite meetings within Cook County IL and surrounding areas/counties (Chicagoland area) * Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy. * 2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) Preferred Qualifications * Crisis intervention skills preferred * Managed care/utilization review experience preferred * Case management and discharge planning experience preferred. Education Minimum of a master's degree required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. Work at home with 50-75% of field based travel in Southwest, West, Central Chicago and surrounding areas. Applicants must reside in Southwest, West, and Central Chicago with preference for those residing in the following zip codes: 60601, 60605, 60606, 60607, 60608, 60609, 60611, 60612, 60616, 60623; 60624, 60632, 60638; 60644, 60653, 60804, 60651, 60642, 60622, 60654. Position Summary The Clinical Case Manager, Behavioral Health, is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CCM, BH, 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 wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. Position Responsibilities: * Responsible for face to face and/or telephonic assessment, planning, implementing and coordinating care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. * Develops a proactive course of action to address issues presented and facilitate short and long-term outcomes as well as identify opportunities to enhance a member's overall health through integration. * Through the use of clinical tools and information/data review, conducts comprehensive assessments of member's needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services. * Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical and social indicators which impact care planning and resolution of member issues. * Completes assessments that take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality and the member's restrictions/limitations. * Analyzes utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. * Applies and interprets 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. * Serves as a single point of contact for members and assists members to remediate immediate and acute gaps in care and access. * Using holistic approach consults with managers, medical directors and/or other physical/behavioral health support staff and providers to overcome barriers to meeting goals and objectives/ * Presents cases at case conferences/rounds to obtain multidisciplinary view in order to achieve optimal outcomes. * Works collaboratively with the members' interdisciplinary care team. * 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 discern their health status and health needs based on key questions and conversation. * 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. * 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. * Facilitates clinical hand offs during transitions of care. Required Qualifications * One of the following active Illinois clinical license is required- LCSW, LCPC, LMFT * Minimum of 2 years of experience in behavioral health or social services field preferably working with individuals living with complex medical needs and disabilities. * Must possess reliable transportation and be willing and able to travel 50-75% of the time to meet members face to face in Southwest, West, Central Chicago and surrounding areas. Mileage is reimbursed per our company expense reimbursement policy. Preferred Qualifications * Case Management and Discharge Planning experience preferred * Managed Care experience preferred * Microsoft Office experience preferred Education Masters degree required, with either degree being in behavioral health or human services preferred Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 03/31/2025 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 ******************************** 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.

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. **Fully remote role with requirement to hold an active Illinois LCSW** **or LCPC license** **. Must reside in Illinois, Wisconsin, Iowa, Missouri, or Indiana and within 3 hour driving time to Chicago or Downer's Grove offices.** **Potential for quarterly meetings in Chicago/Downer's Grove area.** **Position Summary** The Clinical Case Manager, Behavioral Health, is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CCM, BH, 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 wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. **Position Responsibilities: ** + Responsible for telephonic assessment, planning, implementing and coordinating care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. + Develops a proactive course of action to address issues presented and facilitate short and long-term outcomes as well as identify opportunities to enhance a member's overall health through integration. + Through the use of clinical tools and information/data review, conducts comprehensive assessments of member's needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services. + Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical and social indicators which impact care planning and resolution of member issues. + Completes assessments that take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality and the member's restrictions/limitations. + Analyzes utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health 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 and services. + Applies and interprets 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. + Serves as a single point of contact for members and assists members to remediate immediate and acute gaps in care and access. + Using holistic approach consults with managers, medical directors and/or other physical/behavioral health support staff and providers to overcome barriers to meeting goals and objectives/ + Presents cases at case conferences/rounds to obtain multidisciplinary view in order to achieve optimal outcomes. + Works collaboratively with the members' interdisciplinary care team. + 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 discern their health status and health needs based on key questions and conversation. + 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. + 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. + Facilitates clinical hand offs during transitions of care. **Required Qualifications** + - 3+ years of direct clinical practice experience post Clinical Licensure ( LCSW or LCPC), e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility - 5+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) - 2+ years of crisis intervention skills - Illinois-licensed Licensed Clinical Social Worker (LCSW) or LCPC ( Licensed Clinical Professional Counselor with current unencumbered license required **Preferred Qualifications** + Case management and discharge planning experience strongly preferred **Education** + Masters Degree. + Illinois Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor ( LCPC) with current unencumbered license required. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $66,575.00 - $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 ***************************************** We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

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. **Work at home with 50-75% of field based travel in Southwest, West, Central Chicago and surrounding areas.** **Applicants must reside in Southwest, West, and Central Chicago with preference for those residing in the following zip codes: 60601, 60605, 60606, 60607, 60608, 60609, 60611, 60612, 60616, 60623; 60624, 60632, 60638; 60644, 60653, 60804, 60651, 60642, 60622, 60654.** **Position Summary** The Clinical Case Manager, Behavioral Health, is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CCM, BH, 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 wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. **Position Responsibilities: ** + Responsible for face to face and/or telephonic assessment, planning, implementing and coordinating care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. + Develops a proactive course of action to address issues presented and facilitate short and long-term outcomes as well as identify opportunities to enhance a member's overall health through integration. + Through the use of clinical tools and information/data review, conducts comprehensive assessments of member's needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services. + Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical and social indicators which impact care planning and resolution of member issues. + Completes assessments that take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality and the member's restrictions/limitations. + Analyzes utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. + Applies and interprets 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. + Serves as a single point of contact for members and assists members to remediate immediate and acute gaps in care and access. + Using holistic approach consults with managers, medical directors and/or other physical/behavioral health support staff and providers to overcome barriers to meeting goals and objectives/ + Presents cases at case conferences/rounds to obtain multidisciplinary view in order to achieve optimal outcomes. + Works collaboratively with the members' interdisciplinary care team. + 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 discern their health status and health needs based on key questions and conversation. + 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. + 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. + Facilitates clinical hand offs during transitions of care. **Required Qualifications** - One of the following active Illinois clinical license is required- **LCSW, LCPC, LMFT** -Minimum of 2 years of experience in behavioral health or social services field preferably working with individuals living with complex medical needs and disabilities. -Must possess reliable transportation and be willing and able to travel 50-75% of the time to meet members face to face in Southwest, West, Central Chicago and surrounding areas. Mileage is reimbursed per our company expense reimbursement policy. **Preferred Qualifications** -Case Management and Discharge Planning experience preferred -Managed Care experience preferred -Microsoft Office experience preferred **Education** Masters degree required, with either degree being in behavioral health or human services preferred **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $66,575.00 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health (****************************************** We anticipate the application window for this opening will close on: 03/31/2025 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 ******************************** 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. We are an equal opportunity and affirmative action employer. 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.

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. Work at home with requirement to reside in Illinois. Preference for those residing in Cook County or surrounding areas. Potential for up to 15% of travel for occasional face to face visits with members and travel to Downers Grove/Chicago office for meetings. Monday- Friday 8:00 am-5:00 pm. Utilizes advanced clinical judgement 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 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. Required Qualifications * Minimum of 2 years of direct clinical practice experience (e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility) * Must possess active and unrestricted Behavioral Health clinical license (LCSW or LCPC) in the state of Illinois. * Willing and able to travel to meet members face to face and for onsite meetings within Cook County IL and surrounding areas/counties (Chicagoland area) * Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy. * 2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) Preferred Qualifications * Crisis intervention skills preferred * Managed care/utilization review experience preferred * Case management and discharge planning experience preferred. Education Minimum of a master's degree required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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** **Fully remote in the USA.** **Shift Monday-Friday standard business hours. No weekends and no holidays.** 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. **Required Qualifications** + 3 + years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility + 3+ years knowledge of mental health and substance abuse disorders + 3+ years experience talking, speaking on the telephone and typing at the same time + 3+ years experience using Motivational Interviewing and good technological skills + 3+ years Case management and discharge planning experience + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required: (LCSW Licensed Clinical Social Worker, LSW Licensed Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) **Preferred Qualifications** + Crisis intervention skills preferred + Managed care/utilization review experience preferred **Education** Masters Degree in Social Work or Counseling required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $116,760.00 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 ***************************************** We anticipate the application window for this opening will close on: 03/28/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

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. **Position Summary** My Care of Ohio hiring for care management in one of our counties we serve. The applicant must reside in Butler, Clermont, Hamilton, or Warren County in Ohio. We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Licensed Independent Social Worker to join our Case Management team. This opportunity offers a competitive salary and full benefits. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members. Case Manager BH is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Using clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in g functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. **Required Qualifications** - Active and good standing Licensed Independent Social Worker (LISW) for Ohio - 3+ years of behavioral health or social work experience - Must be willing and able to travel up to 50-75% of the time in Hamilton, Butler, Warren or Clermont County. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy. **Preferred Qualifications** - Case management experience - Community social work experience - Computer Skills (Microsoft office such as: Word, Excel, and outlook) **Education** - Masters degree in social work **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $116,760.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health (****************************************** We anticipate the application window for this opening will close on: 04/01/2025 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 ******************************** 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. We are an equal opportunity and affirmative action employer. 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.

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** ***Fully remote*** Schedule : Monday -Friday 9:30 am-6:00 pm EST - Some holidays required. 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 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. + Must be able to multitask + Requires coverage of tasks and inbound clinical queue as needed. **Required qualifications:** + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required: LPC (Licensed Professional Counselor), LP, LMFT (Licensed Marriage and Family Therapists), LCSW (Licensed Clinical Social Workers), LCPC, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist. + 3 + years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility + 2 + year knowledge of mental health and substance abuse disorders . **Preferred Qualifications** + Comfortable talking on the telephone and type at the same time. + Experience using Motivational Interviewing and good technological skills Education : Master's degree in behavioral health field required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $60,522.00 - $129,615.00 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 ***************************************** We anticipate the application window for this opening will close on: 03/30/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

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 * Fully remote* Schedule : Monday -Friday 9:30 am-6:00 pm EST - Some holidays required. 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 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. * Must be able to multitask * Requires coverage of tasks and inbound clinical queue as needed. Required qualifications: * Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required: LPC (Licensed Professional Counselor), LP, LMFT (Licensed Marriage and Family Therapists), LCSW (Licensed Clinical Social Workers), LCPC, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist. * 3 + years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility * 2 + year knowledge of mental health and substance abuse disorders . Preferred Qualifications * Comfortable talking on the telephone and type at the same time. * Experience using Motivational Interviewing and good technological skills Education : Master's degree in behavioral health field required Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 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 ***************************************** We anticipate the application window for this opening will close on: 03/30/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. Position Summary Bilingual Spanish Speaking Fully remote role USA. Standard business hours Monday-Friday. No nights and no weekends. 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. * Telephonic clinical case management with Medicare population. * Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs. * Completes a Comprehensive Assessment and Plan of care. * Will document in clinical systems to support legacy Aetna and Coventry membership. * Provides BH consultation and collaboration with Aetna partners. * Active participation in clinical treatment rounds. * Active participation in team activities focused on program development. Innovative thinking expected. * The majority of time is spent at a desk on telephonic member outreaches and computer documentation. * Assist members with locating community based behavioral health resources. Required Qualifications * 3+ years of direct clinical practice experience * A Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/one or more or equivalent is required (ex: LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist.) * Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service * Bilingual Spanish and English and Must be able to pass language assessment to become certified to speak and write in Spanish. Preferred Qualifications * Crisis intervention skills preferred * Managed care/utilization review experience preferred * Case management and discharge planning experience preferred Education Masters Degree in Social Work or Counseling required Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 03/31/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.