Care Plan Reviewer - Clinical Case Manager Behavioral Health, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

54095.00 - 116760.00 USD / Year

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Job Description:

The Care Plan Reviewer (Clinical Case Manager 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 wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes.

Job Responsibility:

Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare
Conducts comprehensive assessments of referred member's needs/eligibility
Performs crisis intervention with members experiencing a behavioral health or medical crisis
Provides crisis follow up to members
Application and/or interpretation of applicable criteria and clinical guidelines
Identifies and escalates quality of care issues
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement
Provides coaching, information and support to empower the member
In collaboration with the member and their care team develops and monitors established plans of care

Requirements:

Must be Ohio Resident
Active Behavioral Health license in the state Ohio (ex: LMFT, LSW, LPC, LISW)
3+ years of direct clinical practice experience post-Master's degree
2+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a human services or behavioral health care field
2+ years of experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development
Willing and able to travel up to 10% for occasional regional trainings/meetings
Willing to work standard business hours: Monday - Friday, 8am - 5pm
1+ year(s) of experience with personal computers, keyboard, multi-systems navigation, and MS Office Suite applications
Minimum of a Master's degree in Counseling, Social Work, or Marriage and Family Therapy

Nice to have:

Independent clinical license: LPCC, IMFT, or LISW
Managed care/utilization review experience
Case management and discharge planning experience

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
August 27, 2025

Expiration:
September 01, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Care Plan Reviewer - Clinical Case Manager Behavioral Health