Clinical Case Manager Behavioral Health-Spanish Speaking

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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

40

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