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CVS Health

Runs pharmacies, health plans and clinics

Clinical Case Manager Behavioral Health - Transition of Care

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeColumbus, OH, USA

About the Job

Requirements

  • Serve as a clinical consultant and subject matter expert for hospital staff, care coordinators, and community-based professionals supporting members with complex behavioral health needs.
  • Provide coaching, guidance, and education related to behavioral health best practices, care coordination processes, discharge planning, community resources, and care transitions.
  • Collaborate with hospital treatment teams, care management staff, providers, and community partners to identify and address barriers impacting successful care coordination and discharge planning.
  • Support multidisciplinary teams through case consultation, clinical problem-solving, and recommendations designed to improve care outcomes and continuity of care.
  • Facilitate communication and collaboration between healthcare providers, health plan teams, and community organizations to promote integrated care delivery.
  • Use clinical expertise to review complex behavioral health cases, identify potential gaps in care, and recommend appropriate interventions, resources, or escalation pathways.
  • Assist care teams in understanding and applying clinical guidelines, regulatory requirements, organizational policies, and established care management practices.
  • Provide education and support regarding available behavioral health services, community resources, and care coordination tools.
  • Identify trends, barriers, and system-level opportunities impacting member care and communicate findings to leadership and operational partners.
  • Develop and maintain collaborative relationships with hospital leadership, clinical teams, community providers, and internal stakeholders.
  • Participate in interdisciplinary meetings, case conferences, and care coordination discussions to support quality outcomes and effective service delivery.
  • Support quality improvement initiatives, process enhancement efforts, and organizational goals related to behavioral health care coordination and transitions of care.
  • Identify and escalate quality-of-care concerns through established organizational channels.
  • Maintain accurate documentation and reporting in accordance with organizational, regulatory, and accreditation requirements.
  • Represent the organization as a clinical liaison within designated behavioral health facilities.
  • Hold a master's degree in Behavioral Health, Mental Health, Social Work, Counseling, Psychology, or a related field.
  • Hold current, unrestricted behavioral health licensure in Ohio, such as LSW, LPC, MFT, or equivalent.
  • Have strong relationship-building, facilitation, and communication skills.

Responsibilities

  • Provide consultation, coaching, and support to healthcare professionals, care coordination teams, and community partners serving complex behavioral health populations.
  • Promote quality care delivery, appropriate resource utilization, successful transitions of care, and adherence to clinical and organizational standards through collaboration among providers, hospitals, care management teams, and community stakeholders.
  • Function as a clinical liaison and subject matter expert, supporting care teams through education, case consultation, problem-solving, and relationship management.
  • Work in a hybrid environment, including remote work and regular onsite presence at a designated behavioral health hospital.

Desired Qualifications

  • Have 3–5 years of post-master's clinical experience in behavioral health, preferably in inpatient psychiatric, hospital-based, care management, care coordination, or community behavioral health settings.
  • Have experience providing consultation, coaching, education, or support to healthcare professionals.
  • Have experience working collaboratively with hospitals, behavioral health providers, managed care organizations, or multidisciplinary care teams.
  • Have knowledge of care transitions, discharge planning, crisis services, and community behavioral health resources.
  • Have managed care experience.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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