Clinical Case Manager Behavioral Health - Field - Must reside in Cook County Illinois

CVS Health • Chicago, IL

34d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
Join Aetna’s Illinois care management team supporting the D‑SNP FIDE (Fully Integrated Dual Eligible Special Needs Plan) population. As a Behavioral Health Field Case Manager, you will deliver person-centered case management through assessment, planning, care coordination, advocacy, and evaluation to achieve quality, cost-effective outcomes. You will collaborate with members, caregivers, providers, and community partners to address the full continuum of care and social determinants of health, conduct telephonic and in-person outreach within the geographic area of the required location, and support transitions of care. Responsibilities include comprehensive biopsychosocial assessments, individualized care plan development, transitions-of-care support, provider and community coordination, crisis response/intervention and follow-up, application of clinical criteria and guidelines, quality of care identification/escalation, case conferencing, documentation and outcomes evaluation in compliance with regulatory/organizational standards, and ongoing monitoring of goals and outcomes.

Requirements

• Residence: Must reside in/near Cook County IL; Applicable zip codes are 60623, 60624, 60644, or 60804, and be able to travel up to 50-75% of the time within Cook County and surrounding counties for in-person case management activities as needed
• 3–5 years direct, post-master’s clinical practice (e.g., hospital, ambulatory, outpatient, community).
• 2–3 years care management, discharge planning, and/or home health care coordination.
• Proficiency navigating multiple systems, documentation platforms/EMR, and Microsoft 365 (Word, Excel, Outlook, PowerPoint, Teams); able to learn new tools quickly and navigate multiple systems efficiently.
• Proven remote/independent work skills with virtual collaboration tools; excellent communication, organizational, and interpersonal abilities.
• Solid analytical/problem-solving skills; effective case presentation and collaboration with interdisciplinary teams.
• Ability to conduct in-person visits in the community and use motivational interviewing/influencing techniques to drive engagement and behavior change and member-centered coaching.
• Accurate documentation and regulatory compliance; efficient keyboarding.
• Active, unencumbered Illinois BH clinical license - LCSW (Illinois) with a Master’s in Social Work; or
• Active, unencumbered Illinois BH clinical license - LCPC (Illinois) with a Master’s in Counseling or a closely related behavioral health field.

Nice To Haves

• Managed care/utilization review experience.
• Crisis intervention experience (assessment, de-escalation, safety planning, referral, and follow-up) and knowledge of escalation pathways/community crisis resources.
• Additional experience in care management/discharge planning beyond the minimum requirements.
• Experience working with dual-eligible (Medicare/Medicaid) populations and familiarity with Cook County community resources.
• Bilingual Spanish/English preferred to best serve the Little Village community.

Responsibilities

• Deliver person-centered case management through assessment, planning, care coordination, advocacy, and evaluation to achieve quality, cost-effective outcomes.
• Collaborate with members, caregivers, providers, and community partners to address the full continuum of care and social determinants of health
• Conduct telephonic and in-person outreach within the geographic area of the required location
• Support transitions of care
• Comprehensive biopsychosocial assessments
• Individualized care plan development
• Transitions-of-care support
• Provider and community coordination
• Crisis response/intervention and follow-up
• Application of clinical criteria and guidelines
• Quality of care identification/escalation
• Case conferencing
• Documentation and outcomes evaluation in compliance with regulatory/organizational standards
• Ongoing monitoring of goals and outcomes.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees