Must reside in the state of Illinois. Standard business hours Monday
Friday with flexibility needed to meet member needs. This is a field-based position requiring 25-50% travel typically within a 45 mile radius from the candidates residence in order to conduct face to face visits which includes but is not limited to: hospital setting, outpatient clinic, PCP office, or member's residence. The Clinical Care Manager
BH is responsible for care coordination and case management for members, up to age 20, who have experienced a behavioral health crisis event. The Clinical Case Manager
BH: Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member 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: Using 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. 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. Collaboration: Works closely with the family/member identified formal/informal supports involved in the member's care. Routinely communicates with the network provider responsible to screening and follow up after a mobile crisis response event. Partners with Utilization Management to ensure timely and safe discharge to the next level of care. Monitoring, Evaluation and Documentation of Care: In collaboration with the member and/or guardian and their care team, develops and monitors established plans of care to meet the member’s goals. Must be able to multitask. Required Qualifications: Master's prepared behavioral health clinician with unrestricted behavioral health license in the state of Illinois (LCPC, LCSW, LMFT). Must be willing and able to travel 25-50% within a 45 mile radius from the candidates residence. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy. 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 of direct clinical experience working with children and adolescents in settings such as community based organization, residential facility, inpatient setting, group home, mental health clinic, outpatient/residential treatment facility for the management of substance use disorder. 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 experience preferred. Motivational Interviewing Skills preferred. Education: Minimum of a Master's Degree in counseling, social work, or other related field. Anticipated Weekly Hours: 40. Time Type: Full time. Additional information includes CVS Health's commitment to diversity, benefits, COVID-19 vaccination requirements, and equal opportunity employment.
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