Clinical Case Manager, Behavioral Health - Orlando FL

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Clinical Case Manager (CCM), Behavioral Health, is a work from home field-based role with up to 40% travel within Orange, Osceola, Seminole and Brevard counties. The CCM administers processes to coordinate and facilitate comprehensive care for a homeless Medicaid population with Serious Mental Illness and/or Substance Abuse Disorder.

Job Responsibilities

• Enroll eligible members with severe mental illness and/or substance use disorder into the housing pilot program and connect them with housing providers and community resources to meet their needs with the goal of offering permanency-related housing supports to members to break the cycle of chronic homelessness.
• Facilitate comprehensive behavioral health and/or medical care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers.
• Serve as an advocate for members ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.
• Partner, support, and collaborate with Florida State and local housing authorities and leverage these relationships with county housing programs and initiatives to better support the unique needs of our Medicaid members with housing insecurities. 
• Administers the care coordination plan to assess member needs and ensure seamless transitions between different care settings.
• Develops strategies to reduce risk factors and address complex clinical indicators that impact care planning and issue resolution.
• Perform crisis intervention with members experiencing a behavioral health crisis, refer to appropriate providers, and follows up to ensure members are receiving the appropriate services.
• Adapts clinical guidelines, standardized case management procedures, and regulatory standards to needs assessments to ensure appropriate administration of benefits.
• Works collaboratively with the members’ interdisciplinary care team. 
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. 
• 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. 
• Facilitates clinical hand offs during transitions of care. 
• Reports to: Manager, Clinical Health Services  

Required Qualifications

• Must reside in the Orlando area
• Licensed mental health professional with current unencumbered license in the state of FL: Licensed Mental Health Counselor (LMHC), Licensed Marriage & Family Therapist (LMFT), PsyD, or Licensed Clinical Social Worker (LCSW) or active RN licensure with psychiatric experience
• Willing and able to travel up to 40% of their time in the Orlando area including Orange, Osceola, Seminole and Brevard counties to visit members face to face
• 3+ years of direct clinical practice experience post master’s degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility 
• 2+ years of experience managing members with serious mental illness or substance use history
• 2+ years of experience using crisis intervention skills  
• 2+ years of experience providing care to a diverse population
• 2+ years of experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)  

Preferred Qualifications

• Bilingual Spanish
• Experience in assisting members with disa