Clinical Care Manager Behavioral Health - Field
Company: CVS Health
Location: Highland
Posted on: May 28, 2023
|
|
|
Job Description:
Job Description
This is a telework role open to candidates in Madison County and
St. Clair County, IL. This role will require 50-75% travel in the
assigned region.Schedule is Monday-Friday, 8am-5pm CST. No nights,
holidays or weekends.Family Summary/MissionDevelop, implement,
support, and promote Health Services strategies, tactics, policies,
and programs that drive the delivery of quality healthcare to
establish competitive business advantage for Aetna. Health Services
strategies, policies, and programs are comprised of utilization
management, quality management, network management and clinical
coverage and policies.Position Summary/MissionUtilizes advanced
clinical judgment and critical thinking skills to facilitate
appropriate member physical health andbehavioral 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 & Physical Requirements include but are not limited to
(* denotes essential functions)Assessment of Members:--- Through
the use of clinical tools and information/data review, conducts
comprehensive assessments of referredmember's needs/eligibility and
determines approach to case resolution and/or meeting needs by
evaluating member's benefit plan and available internal and
external programs/services.--- 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.--- 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. Provides crisis follow up to members to help
ensure they are receiving the appropriate treatment/services.---
Enhancement of Medical Appropriateness and Quality of Care:-
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--- Using holistic approach consults with supervisors,
Medical Directors and/or other programs to overcome barriers to
meeting goals and objectives; presents cases at case conferences to
obtain multidisciplinary view in order to achieve optimal
outcomes--- Identifies and escalates quality of care issues through
established channels--- Ability to speak to medical and behavioral
health professionals to influence appropriate member care.---
Utilizes influencing/motivational interviewing skills to ensure
maximum member engagement and promotes lifestyle/behavior changes
to achieve optimum level of health--- Provides coaching,
information and support to empower the member to make ongoing
independent medical and/orhealthy lifestyle choices.--- Helps
member actively and knowledgably participate with their provider in
healthcare decision-making --- Analyzes all utilization,
self-report and clinical data available to consolidate information
and begin to identifycomprehensive member needs.--- Monitoring,
Evaluation and Documentation of Care:-In collaboration with the
member and their care team develops and monitors established plans
of care to meet the member's goals--- Utilizes case management and
quality management processes in compliance with regulatory and
accreditationguidelines and company policies and procedures.
Pay Range
The typical pay range for this role is:
Minimum: 58,760
Maximum: 125,840
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
Required Qualifications
COVID Requirements
COVID-19 Vaccination Requirement
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.
Preferred Qualifications
Education
Master's Degree required
Business Overview
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. We strive to promote and
sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal
opportunity employer, as are the physician-owned businesses for
which CVS Health provides management services. We do not
discriminate in recruiting, hiring, promotion, or any other
personnel action based on race, ethnicity, color, national origin,
sex/gender, sexual orientation, gender identity or expression,
religion, age, disability, protected veteran status, or any other
characteristic protected by applicable federal, state, or local
law. We proudly support and encourage people with military
experience (active, veterans, reservists and National Guard) as
well as military spouses to apply for CVS Health job
opportunities.
Keywords: CVS Health, Springfield , Clinical Care Manager Behavioral Health - Field, Executive , Highland, Illinois
|
Click
here to apply!
|
