Behavioral Health Case Manager / Member Navigator
About The Position
The Behavioral Health Case Manager / Member Navigator provides direct support to members experiencing behavioral health needs, helping them navigate the healthcare system and remain connected to care. The role addresses quality gaps and barriers that can arise after a member leaves a facility or receives a referral, such as appointment scheduling, transportation, provider understanding, medication access, and social determinants that affect treatment engagement. The position supports continuity of care and prevention of avoidable readmissions by intervening quickly during high-risk transitions, coordinating with providers and care teams, and connecting members to treatment and community resources.
Requirements
- Prior clinical and/or managed care experience in the healthcare industry or quality management.
- Bachelor’s degree.
Nice To Haves
- Behavioral Health experience.
- Case management and discharge planning experience.
- Managed Care experience.
Responsibilities
- Conduct outreach to members following behavioral health inpatient admissions and emergency department visits.
- Facilitate timely follow-up appointments.
- Improve member engagement with behavioral health treatment plans.
- Address barriers to accessing care.
- Connect members with community and social support resources.
- Coordinate with providers, care managers, and population health teams.
- Act on ADT notifications and discharge information to intervene quickly during high-risk transition periods.
- Support continuity of care and prevention of avoidable readmissions.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources to support colleagues and their families, based on eligibility
- Eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay
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What This Job Offers
Job Type
Full-time
