Clinical Case Manager Behavioral Health-Spanish Speaking
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About The Position
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 Fully remote in USA. Shift: Monday-Friday standard business hours in time zone of residence No nights, no weekends, no holidays and no on call. The Clinical Case Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. * The telephonic clinical case manager applies clinical judgment and incorporates the strategies designed to reduce risk factors for readmission and addresses complex clinical indicators which impact care planning and resolution of member issues. * Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs. * Using clinical tools and information/data review, conducts comprehensive assessments of member's needs and determines approach to case resolution and meeting needs by evaluating member's benefit plan and available internal and external programs and services with intent of reducing readmissions. * Will document in healthcare clinical systems to support ACA Individual Family Plan population. * Provides BH consultation and collaboration with Aetna partners and other Shared Services with active participation in Interdisciplinary Care Team case conferences. * Active participation in team activities focused on program development. Innovative thinking expected. * This is a telephonic remote position, that is member-facing role with primary responsibility that includes member outreaches and computer documentation. * Assist members completing medication reconciliation, provider referrals for aftercare and locating community based behavioral health resources as well as locating resources for social determinants of health.
