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Position Summary

This is a telework position with up to 50% travel to meet members face to face in Bexar County, Texas.

The schedule is Monday-Friday, 8am-5pm.

Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies.
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
 

Assessment of Members: Through the use of 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. - Applies clinical judgment

A Brief Overview
Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.

What you will do

• Coordinates behavioral health assessments to gain information on substance abuse history and mental health; determines the most appropriate social support system for patient health.
• Develops a complex resource coordination system to assists with outpatient counseling, support groups, housing assistance, vocational rehabilitation, or medication management.
• Documents individualized treatment plans based on assessments; develops plans which include goals, interventions, and measurable outcomes.
• Configures electronic medical software to categorize behavioral health conditions by severity.
• Edits content for the clinical advocacy campaign to deliver an impactful message surrounding client rights and health needs.
• Examines the data management system to ensure compliance with data privacy and security regulations.
• Identifies opportunities to develop training programs for the clinical case manager to ensure a thorough understanding of behavioral health practices.
• implements a monitoring and evaluation system to monitor patient progress towards goals.
• Installs an electronic medical record to monitor the input and output of the clinical case department.

Required Qualifications

• Must reside in Bexar County or the surrounding area
• Willing and able to travel up to 50% of their time to meet members face to face throughout Bexar County. Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy.
• Unencumbered Behavioral Health clinical TX state license required (Ex - LMSW, LCSW, LPC, LMFT, etc.)
• 3+ years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic and/or facility
• Minimum 1 year of Case management experience

Preferred Qualifications

• Discharge planning experience
• Crisis intervention skills
• Managed care experience
• Experience with youth and behavioral health.
• Bilingual in Spanish.

Education

• Minimum of a Master's degree in Behavioral/Mental Health, social services or human services

Pay Range

The typical pay range for this role is:

$60,522.80 - $129,615.20

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 09/30/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.