Case Manager Behavioral Health - LCSW or LCPC (Field - Chinatown area)

CVS Health • Chicago, IL

11d

About The Position

CVS Health’s Aetna team is seeking a behavioral health case manager to support members enrolled in Medicare and Medicaid who have complex health and social challenges. The role uses a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy to connect members and families with appropriate services and resources and promote quality, cost-effective outcomes. The position serves the South Loop, Chinatown, and surrounding areas of Illinois, with substantial field travel.

Requirements

• Must reside in Illinois.
• 3–5 years of clinical practical experience.
• 2–3 years of case management, discharge planning, and/or home health care coordination experience.
• Must hold an LCSW or LCPC license in Illinois.
• Must have reliable transportation and be willing and able to travel up to 50–75% in the South Loop, Chinatown, and surrounding areas; mileage is reimbursed under the company expense reimbursement policy.
• Confidence working independently from home and collaborating with teams virtually.
• Strong analytical and problem-solving skills.
• Effective communication, organizational, and interpersonal skills.
• Ability to work independently.
• Proficiency with standard corporate software, including MS Word, Excel, Outlook, and PowerPoint, as well as some proprietary applications.
• Efficient computer skills, including navigating multiple systems and keyboarding.
• Master’s degree in behavioral or mental health, or a related field.

Nice To Haves

• Certified Case Manager certification.
• Bilingual ability.

Responsibilities

• Assess referred members’ needs and eligibility using clinical tools, information, and data; determine case-resolution approaches based on benefits and available internal and external programs.
• Apply clinical judgment to develop strategies that reduce risk factors and address complex clinical indicators affecting care planning and resolution of member issues.
• Provide crisis intervention for members experiencing behavioral health or medical crises, refer them to appropriate clinical providers, and follow up on treatment and services.
• Apply or interpret clinical criteria, guidelines, case management plans, policies, procedures, and regulatory standards when assessing benefits and member needs.
• Consult with supervisors, Medical Directors, and other programs to address barriers; present cases at conferences to obtain multidisciplinary perspectives.
• Identify and escalate quality-of-care issues through established channels.
• Communicate with medical and behavioral health professionals to influence appropriate member care.
• Use motivational interviewing and other influencing skills to engage members and promote lifestyle or behavior changes.
• Coach and support members so they can make informed, independent medical and healthy-lifestyle choices and participate in healthcare decisions with their providers.
• Analyze utilization, self-reported, and clinical data to identify comprehensive member needs.
• Develop and monitor plans of care with members and their care teams.
• Use case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• CVS Health bonus, commission, or short-term incentive program eligibility
• Other resources to support colleagues’ physical, emotional, and financial well-being, based on eligibility

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level