Care Manager - Behavioral Health
HumanaSalary not specified
Full Time
Mid-level (3 to 4 years)
Clinical Case Manager Behavioral Health- Field at CVS Health
Schaumburg, Illinois, United States
Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- Clinical licensure
- Minimum two years experience working with children living with special needs or children in foster care
- Willing and able to travel up to 50-75% of their time to meet members face to face within one hour of their location
- Reliable transportation required; mileage is reimbursed per company expense reimbursement policy
Responsibilities
- Executes evaluation of member needs and benefit plan eligibility and facilitates member transition to the organization's programs and plans
- Applies advanced clinical judgement to incorporate strategies designed to reduce risk factors and barriers, and to address complex health indicators that impact care planning and resolution of member issues
- Handles reviews of prior claims to address potential impact on current case management and eligibility
- Creates a holistic approach to assess the need for referrals to clinical resources and to assist in determining functionality
- Ensures case management processes follow organization and regulatory requirements
- Implements systems to maximize member engagement, discern health status and needs, and to assess member levels of work capacity and restrictions
- Coaches and trains junior colleagues in techniques, processes, and responsibilities
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What is the pay range for this Clinical Case Manager position?
The typical pay range is $66,575.00 - $142,576.00, depending on factors like experience, education, geography, and other relevant factors. This position is also eligible for a CVS Health bonus.
Is this a remote position, and what's the travel requirement?
This is a telework position with up to 50-75% travel in the designated region of Illinois. Reliable transportation is required, and mileage is reimbursed per company policy.
What are the required qualifications for this role?
Candidates must have clinical licensure, a minimum of two years experience working with children living with special needs or children in foster care, and be willing and able to travel up to 50-75% of their time.
What education is preferred for this position?
A Masters Degree in Social Work or any related field is preferred.
What makes a strong candidate for this Clinical Case Manager role?
Strong candidates will have clinical licensure, at least two years of experience with children in special needs or foster care, managed care or case management experience, and a Master's in Social Work or related field.
CVS Health
Comprehensive pharmacy and healthcare services
About CVS Health
CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.
Woonsocket, Rhode IslandHeadquarters
1963Year Founded
DEBTCompany Stage
Healthcare, Consumer GoodsIndustries
10,001+Employees
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Disability Insurance
401(k) Retirement Plan
Company Equity
Wellness Program
Professional Development Budget
Paid Vacation
Paid Holidays
Risks
Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.
The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.
The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.
Differentiation
CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.
The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.
CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.
Upsides
Expansion of telehealth services allows CVS to reach more patients remotely.
Increased consumer interest in wellness boosts demand for CVS's health-related products.
The trend towards value-based care aligns with CVS's integrated healthcare approach.
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