About The Position

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. 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 This position offers a $5,000 New Hire Bonus! This BH Case Manager position is with Aetna’s Long-Term Services and Supports (LTSS) team and is a field-based position out of McHenry County IL or Surrounding Areas (Applicable Zip Codes: 60013, 60014, 60050, 60098, 60102, 60110, 60142, 60152, 60156,60614). Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues Determines medical necessity/ appropriateness Facilitates optimal outcomes Identifies and follow through with continuous quality/ compliance opportunities. May also include identification of aberrance's and initiation of corrective action Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy Optimize total costs Implementation and evaluation of policy based on usage and program directives Educate/empower colleagues at all levels to enable decision making at most appropriate level

Requirements

  • Active IL BH clinical license - LCSW, LCPC, LMFT.
  • Minimum of 2 years of experience in behavioral health or social services field.
  • Must reside in McHenry County IL or Surrounding Areas (Applicable Zip Codes: 60013, 60014, 60050, 60098, 60102, 60110, 60142, 60152, 60156, 60614).
  • Willing and able to travel up to 50-75% of their time to meet with members face to face in Northside Chicago/ loop and surrounding areas.
  • Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy.

Nice To Haves

  • Case management and discharge planning experience.
  • Managed Care experience.
  • Microsoft Office experience.
  • Experience working with HIV and AIDS population.

Responsibilities

  • Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment
  • Effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issues
  • Determines medical necessity/ appropriateness
  • Facilitates optimal outcomes
  • Identifies and follow through with continuous quality/ compliance opportunities
  • May also include identification of aberrance's and initiation of corrective action
  • Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacy
  • Optimize total costs
  • Implementation and evaluation of policy based on usage and program directives
  • Educate/empower colleagues at all levels to enable decision making at most appropriate level

Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume

What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

5,001-10,000 employees

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service