Clinical Case Manager Behavioral Health - Field - Must reside in Essex County NJ

At CVS Health, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nations leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary:

The Clinical Case Manager Behavioral Health is responsible for conducting in-person, comprehensive assessments for members enrolled in the Managed Long-Term Services and Supports (MLTSS) program and/or Dual Special Needs Program (D-SNP/FIDE). This role may also include evaluating non-MLTSS members to determine medical and support needs, facilitating access to services that promote overall wellness and independence.

Key Responsibilities:

• Conduct face-to-face assessments to evaluate member needs and eligibility for services such as adult/pediatric medical daycare, personal care assistance, nursing facility custodial care, the Personal Preference Program, and MLTSS enrollment.
• Collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams to develop and implement individualized care plans.
• Authorize services within the MLTSS/FIDE benefit structure and coordinate access to community-based resources.
• Participate in interdisciplinary team meetings and advocate on behalf of members to ensure appropriate care and support.
• Accurately and promptly document all assessments, care plans, and communications in the electronic health record system.
• Apply critical thinking and problem-solving skills to address member needs and resolve care-related issues.
• Mentor new hires upon achieving proficiency in the role.
• Maintain compliance with all regulatory and organizational requirements, including successful completion of the NJ Choice Certification (required for continued employment).

Work Environment & Travel:

• This is a telework position requiring availability during standard business hours of Monday -Friday 8-5 EST.
• Travel is required 5075% of the time within Essex County and surrounding areas.

Required Qualifications:

• Must reside in Essex County
• Licensed Clinical Social Worker or Licensed Social Worker in NJ
• 2+ years Behavioral Health experience/expertise
• Strong clinical assessment, communication, and documentation skills.
• Ability to work independently while collaborating effectively with a multidisciplinary team.
• Commitment to delivering person-centered, culturally competent care.
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.

Preferred Qualifications

• Case management and/or discharge planning experience
• Managed Care experience
• Crisis intervention skills
• Proficiency using computers, keyboards and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams, etc.)

Education

• Master's Degree in Social Work or Behavioral Health field required

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• 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.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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