Clinical Case Manager Behavioral Health-Spanish Speaking @ CVS Health

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

As the nation’s 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

Fully remote in USA.

Shift: Monday-Friday standard business hours in time zone of residence

No nights, no weekends, no holidays and no on call.

The Clinical Case Manager 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.

The telephonic clinical case manager applies clinical judgment and incorporates the strategies designed to reduce risk factors for readmission and addresses complex clinical indicators which impact care planning and resolution of member issues.
Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs.
Using clinical tools and information/data review, conducts comprehensive assessments of member’s needs and determines approach to case resolution and meeting needs by evaluating member’s benefit plan and available internal and external programs and services with intent of reducing readmissions
Will document in healthcare clinical systems to support ACA Individual Family Plan population.
Provides BH consultation and collaboration with Aetna partners and other Shared Services with active participation in Interdisciplinary Care Team case conferences.
Active participation in team activities focused on program development. Innovative thinking expected.
This is a telephonic remote position, that is member-facing role with primary responsibility that includes member outreaches and computer documentation.
Assist members completing medication reconciliation, provider referrals for aftercare and locating community based behavioral health resources as well as locating resources for social determinants of health.

Required Qualifications

3+ years of direct clinical practice experience
Master's degree in behavioral health field with unrestricted license in state of residence (ex: LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist.), or active Compact RN license with extensive behavioral health background (BSN preferred)
2+ year of experience with Microsoft Office applications (Outlook, Teams, Excel)
Must have dedicated work area established with high speed internet connection with ethernet hard line connection
Bilingual Spanish and English

Preferred Qualifications

Crisis intervention skills
Managed care or utilization review experience
Case management and discharge planning experience
Substance Use Disorder experience
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually

Education

Master’s Degree in Social Work or Counseling required OR RN with 3 years of behavioral health experience

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$72,627.00 - $155,538.00

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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/09/2025

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

Clinical Case Manager Behavioral Health-Spanish Speaking

CVS Health

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