Clinical Case Manager Behavioral Health - Transition of Care - Must live in Columbus, Ohio area
About The Position
CVS Health is hiring a Clinical Case Manager Behavioral Health focused on transitions of care. The role uses advanced clinical expertise, critical thinking, and behavioral health knowledge to advise, coach, and support healthcare professionals, care coordination teams, and community partners who serve people with complex behavioral health needs. The position promotes quality care, appropriate resource use, successful care transitions, and adherence to clinical and organizational standards. The role serves as a clinical liaison and subject matter expert, providing education, case consultation, problem-solving, and relationship management. It collaborates with providers, hospitals, care management teams, and community stakeholders to support integrated care delivery and continuity of care. The position operates in a hybrid work environment, with remote work and regular onsite presence at Sun Behavioral Hospital in Columbus, Ohio. The employee must live in the Columbus, Ohio area. The stated schedule is Monday through Friday, 40 hours per week.
Requirements
- Master's degree in Behavioral Health, Mental Health, Social Work, Counseling, Psychology, or a related field.
- Current, unrestricted behavioral health licensure in Ohio, such as LSW, LPC, MFT, or equivalent.
- Strong relationship-building, facilitation, and communication skills.
- Must live in the Columbus, Ohio area.
Nice To Haves
- 3–5 years of post-master's clinical experience in behavioral health, preferably in inpatient psychiatric, hospital-based, care management, care coordination, or community behavioral health settings.
- Experience providing consultation, coaching, education, or support to healthcare professionals.
- Experience working with hospitals, behavioral health providers, managed care organizations, or multidisciplinary care teams.
- Knowledge of care transitions, discharge planning, crisis services, and community behavioral health resources.
- Managed care experience.
Responsibilities
- Serve as a clinical consultant and subject matter expert for hospital staff, care coordinators, and community-based professionals supporting members with complex behavioral health needs.
- Provide coaching, guidance, and education on behavioral health best practices, care coordination processes, discharge planning, community resources, and care transitions.
- Collaborate with hospital treatment teams, care management staff, providers, and community partners to identify and address barriers to care coordination and discharge planning.
- Support multidisciplinary teams through case consultation, clinical problem-solving, and recommendations to improve care outcomes and continuity of care.
- Facilitate communication and collaboration among healthcare providers, health plan teams, and community organizations.
- Review complex behavioral health cases, identify potential gaps in care, and recommend interventions, resources, or escalation pathways.
- Help care teams understand and apply clinical guidelines, regulatory requirements, organizational policies, and established care management practices.
- Provide education and support on behavioral health services, community resources, and care coordination tools.
- Identify trends, barriers, and system-level opportunities affecting member care, and communicate findings to leadership and operational partners.
- Develop and maintain collaborative relationships with hospital leadership, clinical teams, community providers, and internal stakeholders.
- Participate in interdisciplinary meetings, case conferences, and care coordination discussions.
- Support quality improvement initiatives, process enhancements, and organizational goals related to behavioral health care coordination and transitions of care.
- Identify and escalate quality-of-care concerns through established organizational channels.
- Maintain accurate documentation and reporting in accordance with organizational, regulatory, and accreditation requirements.
- Represent the organization as a clinical liaison within designated behavioral health facilities.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- Eligibility for a CVS Health bonus, commission, or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
