Clinical Case Manager BH-Field-Virginia
Company: CVS Health
Location: Richmond
Posted on: November 20, 2023
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Job Description:
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.
Hours for this position are Monday-Friday 8:00am to 5:00pm EST.The
Clinical Case Manager BH 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.Fundamental Components:
Assessment of Members:o Conducts face-to-face member visits.o
Through the use of clinical tools and information/datareview,
conducts comprehensive assessments of referredmember's
needs/eligibility and determines approach tocase resolution and/or
meeting needs by evaluatingmember's benefit plan and available
internal and externalprograms/services.o Applies clinical judgment
to the incorporation of strategies designed to reduce risk factors
and address complex clinical indicators which impact care planning
and resolution of member issues.o Using advanced clinical skills,
performs crisis intervention with members experiencing a behavioral
health or medical crisis and refers them to the appropriate
clinical providers for thorough assessment and treatment, as
clinically indicated.o Provides crisis follow up to members to help
ensure they are receiving the appropriate treatment/services.
Enhancement of Medical Appropriateness and Quality of Care:o
Application and/or interpretation of applicable criteria and
clinical guidelines, standardized case management plans, policies,
procedures, and regulatory standards while assessing benefits
and/or member's needs to ensure appropriate administration of
benefits.o Using holistic approach consults with
supervisors,Medical Directors and/or other programs to
overcomebarriers to meeting goals and objectives; presents cases at
case conferences to obtain multidisciplinary view in order to
achieve optimal outcomes.o Identifies and escalates quality of care
issues throughestablished channels.o Ability to speak to medical
and behavioral healthprofessionals to influence appropriate member
care.o Utilizes motivational interviewing skills to ensuremaximum
member engagement and promoteslifestyle/behavior changes to achieve
optimum level ofhealth.o Provides coaching, information and support
to empower the member to make ongoing independent medical
and/orhealthy lifestyle choices.o Helps member actively and
knowledgably participate withtheir provider in healthcare
decision-making.o Analyzes all utilization, self-report and
clinical dataavailable to consolidate information and begin to
identifycomprehensive member needs.
Monitoring, Evaluation and Documentation of Care:o In collaboration
with the member and their care teamdevelops and monitors
established plans of care to meetthe member's goals.o Utilizes case
management and quality managementprocesses in compliance with
regulatory and accreditationguidelines and company policies and
procedures.
Required Qualifications:
3+ years of direct clinical practice experience post Master's
degree (e.g., hospital setting or alternative care setting such as
ambulatory care or outpatient clinic/facility).
Unencumbered Behavioral Health clinical license in VA (LCSW, LPC or
LBA)
Must have reliable transportation and must be willing and able to
travel within the assigned region 25-40% of the time. Mileage is
reimbursed per our company expense reimbursement policy.
Preferred Qualifications:
2+ years demonstrated experience with personal computer, keyboard,
mouse, multi-system navigation, and with MS Office Suite
applications (Outlook, Word, Excel, SharePoint).
Crisis intervention skills
Medicaid experience
Managed care experience
Case management and discharge planning
Experience with Substance Use Disorders
Education
Master's in Social Work, Behavior, Professional Counseling,
Marriage and Family.
Pay Range
The typical pay range for this role is:
$58,760.00 - $125,840.00
This pay range represents the base hourly rate or base annual
full-time salary for all positions in the job grade within which
this position falls. The actual base salary offer will depend on a
variety of factors including experience, education, geography and
other relevant factors. This position is eligible for a CVS Health
bonus, commission or short-term incentive program in addition to
the base pay range listed above. In addition to your compensation,
enjoy the rewards of an organization that puts our heart into
caring for our colleagues and our communities. The Company offers a
full range of medical, dental, and vision benefits. Eligible
employees may enroll in the Company's 401(k) retirement savings
plan, and an Employee Stock Purchase Plan is also available for
eligible employees. The Company provides a fully-paid term life
insurance plan to eligible employees, and short-term and long term
disability benefits. CVS Health also offers numerous well-being
programs, education assistance, free development courses, a CVS
store discount, and discount programs with participating partners.
As for time off, Company employees enjoy Paid Time Off ("PTO") or
vacation pay, as well as paid holidays throughout the calendar
year. Number of paid holidays, sick time and other time off are
provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits
CVS Health requires certain colleagues to be fully vaccinated
against COVID-19 (including any booster shots if required), where
allowable under the law, unless they are approved for a reasonable
accommodation based on disability, medical condition, religious
belief, or other legally recognized reasons that prevents them from
being vaccinated.
You are required to have received at least one COVID-19 shot prior
to your first day of employment and to provide proof of your
vaccination status or apply for a reasonable accommodation within
the first 10 days of your employment. Please note that in some
states and roles, you may be required to provide proof of full
vaccination or an approved reasonable accommodation before you can
begin to actively work.
CVS Health is committed to recruiting, hiring, developing,
advancing, and retaining individuals with disabilities. As such, we
strive to provide equal access to the benefits and privileges of
employment, including the provision of a reasonable accommodation
to perform essential job functions. CVS Health can provide a
request for a reasonable accommodation, including a qualified
interpreter, written information in other formats, translation or
other services through ColleagueRelations@CVSHealth.com If you have
a speech or hearing disability, please call 7-1-1 to utilize
Telecommunications Relay Services (TRS). We will make every effort
to respond to your request within 48 business hours and do
everything we can to work towards a solution.
Keywords: CVS Health, Richmond , Clinical Case Manager BH-Field-Virginia, Executive , Richmond, Virginia
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