Full-Time

Clinical Case Manager Behavioral Health LCSW/LCPC

Confirmed live in the last 24 hours

CVS Pharmacy

CVS Pharmacy

10,001+ employees

Retail pharmacy and healthcare services provider

Healthcare
Consumer Goods

Compensation Overview

$66.6k - $142.6kAnnually

+ Bonus + Commission + Short-term Incentive Program

Mid

Company Historically Provides H1B Sponsorship

Chicago, IL, USA

Ability to travel 50-75% within the South and Southwest Chicago Area.

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Required Skills
Data Analysis
Requirements
  • 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/facility
  • Ability to travel 50-75% within the South and Southwest Chicago Area
  • Active and unrestricted LCSW or LCPC licensure in IL
  • Minimum of a Master’s Degree in Behavioral/Mental Health or related field
Responsibilities
  • Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
  • Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.
  • 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 to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.
  • Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services.
  • Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits.
  • Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes.
  • Identifies and escalates quality of care issues through established channels.
  • Ability to speak to medical and behavioral health professionals to influence appropriate member care.
  • Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health.
  • Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
  • Helps member actively and knowledgably participate with their provider in healthcare decision-making.
  • Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.
  • In collaboration with the member and their care team develops and monitors established plans of care to meet the member’s goals.
  • Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also functions as a pharmacy benefits manager, serving over 75 million plan members, and has a senior pharmacy care business that assists more than one million patients each year. This integrated approach allows CVS to deliver affordable health management solutions, improving access to quality care and health outcomes while aiming to reduce overall healthcare costs. Unlike many competitors, CVS Health combines retail pharmacy services with clinical care and pharmacy benefits management, making it a significant player in the healthcare sector with a goal of helping individuals achieve better health.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

Growth & Insights
Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
Simplify Jobs

Simplify's Take

What believers are saying

  • Expansion of telehealth services enhances CVS's accessible and convenient care options.
  • Growing interest in wellness allows CVS to expand preventive care product lines.
  • Value-based care models align with CVS's integrated approach, improving care quality.

What critics are saying

  • DOJ's civil complaint may lead to financial penalties for CVS.
  • Reputational damage from DOJ's lawsuit could erode consumer trust in CVS.
  • Competition from Walmart and Amazon in at-home health tests challenges CVS's market share.

What makes CVS Pharmacy unique

  • CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.
  • CVS's integrated model includes a leading pharmacy benefits manager with 75 million members.
  • CVS offers a comprehensive range of health services, enhancing access to quality care.

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