Behavioral Health Clinical Case Manager- Eastern Mountain Region

CVS Health•Pikeville, KY

7d•$54,095 - $116,760•Hybrid

About The Position

The Behavioral Health Clinical Case Manager applies advanced clinical judgment to facilitate appropriate physical health and behavioral healthcare for members. The role assesses and plans care, directs collaboration with providers, and coordinates psychosocial wraparound services, using available resources to support optimal, cost-effective outcomes. This is a field-based role in Kentucky’s Eastern Mountain Region, with field work approximately 50% of the time. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with flexibility required due to the nature of the role and travel. The position also has work-from-home requirements, including a secure, private workspace and a direct-wired internet connection meeting specified speed requirements. CVS Health provides computer equipment; the employee supplies workspace furniture. The role is full-time, with 40 anticipated weekly hours. The position requires an active, unrestricted behavioral health professional license in accordance with state requirements, a relevant master’s degree, and at least three years of relevant experience. The employee must reside in the Eastern Mountain Region of Kentucky. The stated base pay range is $54,095 to $116,760, with eligibility for a CVS Health bonus, commission, or short-term incentive program. Benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Requirements

Active, unrestricted licensure as an LCSW, LPC, LMFT, Psychologist, or other qualified behavioral health professional in accordance with state requirements.
Master’s degree in Social Work, Counseling, Psychology, Human Services, or a related behavioral health field.
At least three years of experience in behavioral health, case management, care coordination, or a related setting.
Experience conducting behavioral health assessments and developing member-centered care plans.
Knowledge of mental health, substance use disorders, trauma-informed care, recovery principles, and community-based services.
Experience coordinating care across providers, families, community agencies, and other service systems.
Strong communication, clinical judgment, documentation, and organizational skills.
Ability to manage complex cases and support members with behavioral health and psychosocial needs.
Proficiency with electronic health records and care management systems.
Must reside in the Eastern Mountain Region of Kentucky, including Breathitt, Floyd, Johnson, Knott, Lee, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike, or Wolfe County.
Must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted.
Must maintain a quiet, secure, private, tidy, and organized designated home work location that complies with CVS Health and HIPAA guidelines and allows uninterrupted work.
Work-from-home colleagues must work within the state and city where they have confirmed they currently live.
Must provide workspace furniture, such as a desk or standing desk, and commit to meeting work-from-home requirements.
Comfort using multiple monitors and navigating multiple applications simultaneously.
Ability to use digital communication tools, including email, calendar invitations, Teams messaging, and virtual meetings.
Experience with Microsoft Office 365 applications or similar tools such as Google Workspace.
Ability to access secure systems, follow security practices, and recognize suspicious emails or links.
Ability to troubleshoot common technical issues independently and contact IT for unresolved issues.
Openness to learning new skills as the workplace environment evolves.

Nice To Haves

Experience in Medicaid managed care, community mental health, child welfare, or foster care populations.
Experience working with members with serious mental illness (SMI), serious emotional disturbance (SED), substance use disorders (SUD), or co-occurring conditions.
Case Management Certification (CCM) or a related certification.

Responsibilities

Conduct behavioral health and psychosocial assessments.
Develop, implement, and monitor individualized care plans.
Coordinate services across behavioral health, medical, and community providers.
Support discharge planning and transitions of care.
Advocate for members and connect them to community resources.
Monitor member progress, identify barriers, and facilitate problem-solving to improve outcomes.
Participate in interdisciplinary care team meetings and provider collaboration.
Apply available resources to support optimal, cost-effective outcomes.