Clinical Case Manager – Behavioral Health, CVS Health

CVS Health

Location:
United States, Bridgeton

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

72627.00 - 155538.00 USD / Year

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Job Description:

The Clinical Case Manager is responsible for developing and executing health service strategies that promote high-quality, cost-effective care for members. This includes utilization management, quality improvement, network coordination, and adherence to clinical policies.

Job Responsibility:

Conduct face-to-face assessments for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE)
Evaluate member needs and coordinate services such as medical daycare (adult/pediatric), personal care assistance, nursing facility placement, and MLTSS enrollment
Collaborate with members, caregivers, providers, and interdisciplinary teams to create and implement individualized care plans
Authorize services in accordance with program guidelines and connect members to appropriate community resources
Accurately and promptly document all case management activities in the electronic health record
Apply advanced clinical judgment and critical thinking to resolve complex care issues
Mentor new hires once proficient in the role.

Requirements:

Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW)
Minimum of 2 years of behavioral health experience
Strong assessment, communication, and documentation skills
Successful completion of NJ Choice Certification (minimum score of 80% required for continued employment)
Ability to work independently in a remote environment during standard business hours
Reliable transportation and willingness to travel up to 75% of the time (mileage reimbursed per company policy)
Flexibility to occasionally cover Cumberland County, NJ.

Nice to have:

Experience in case management and/or discharge planning
Background in managed care
Crisis intervention skills.

What we offer:

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
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access.

Additional Information:

Job Posted:
October 02, 2025

Expiration:
October 31, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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Clinical Case Manager – Behavioral Health