Clinical Case Manager Behavioral Health – Field - Must reside in Western Chicago Suburbs at CVS Health

Elmhurst, Illinois, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Active Illinois Behavioral Health clinical license (specifically LCSW, LCPC, or LMFT)
Must reside in Addison, Elmhurst, Lombard, Oak Brook, or surrounding western Chicago suburban area
Valid Illinois Driver's License
Willing and able to travel 50-75% of time for face-to-face member meetings
Reliable transportation (eligible for mileage reimbursement per company policy)
Minimum two (2) years of case management experience
Microsoft Office and electronic health record experience
Master's degree in social work, counseling, or related field

Responsibilities

Conduct comprehensive evaluation of referred members' needs/eligibility using care management tools and data review, recommend case resolution approaches, evaluate benefit plans, and identify internal/external programs/services
Identify high risk factors and service needs impacting member outcomes, with referrals to clinical case management or crisis intervention as appropriate
Coordinate and implement assigned care plan activities and monitor care plan progress
Consult with case managers, supervisors, Medical Directors, and others using a holistic approach to overcome barriers; present cases at conferences for multidisciplinary review to achieve optimal outcomes
Identify and escalate quality of care issues through established channels
Utilize negotiation skills to secure appropriate options and services meeting member's benefits/healthcare needs
Use influencing/motivational interviewing skills to ensure member engagement, promote lifestyle/behavior changes, provide coaching/information/support for independent medical/healthy lifestyle choices, and facilitate provider participation in decision-making
Manage a full caseload of waiver/LTSS members, including in-person quarterly visits to meet contractual requirements
Utilize case management and quality management processes in compliance with regulatory, accreditation guidelines, and company policies/procedures

Skills

LCSW

LCPC

LMFT

Behavioral Health

Care Coordination

Case Management

LTSS

Care Planning

Crisis Intervention

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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