Behavioral Health Care Planner

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.

Care Planner - Behavioral Health (Work at Home, U.S.)

Schedule: Monday-Friday, 11:00 AM-7:30 PM EST (Some company holiday and weekend coverage may be required)
Location: Work from your home, anywhere in the United States

Join the Behavioral Health Division of Aetna/CVS Health as a Care Planner, where you'll play a meaningful part in helping members access the behavioral health support and documentation they need. In this role, you'll collaborate with Medical Directors, clinicians, and customer service teams to support higher‑level case reviews and ensure timely, accurate processing.

You'll also help maintain our state regulatory compliance and support our NCQA accreditation-key functions that keep our care programs running smoothly and effectively.

• Support clinical teams to enhance the quality and coordination of member care
• Prepare administrative and medical‑necessity determination letters with accuracy and clarity
• Communicate results of medical reviews to providers and utilization teams, including next steps
• Schedule and coordinate appointments between providers and Aetna Medical Directors or Consultants
• Gather appropriate documentation for clinical appointments and track deadlines to ensure timely completion
• Ensure compliance with state requirements and Aetna policies, using strong attention to detail across varying protocols

• 2+ years of experience in at least one of the following:
  • Health insurance
  • Administrative/secretarial work
  • Customer service within a healthcare or mental health environment
• Ability to type 60-70 words per minute
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel)

• Strong organizational and time‑management abilities
• Excellent written and verbal communication skills
• Understanding of commercial insurance products
• Understanding of mental health and substance abuse related levels of care
• Strong attention to detail and ability to problem solve to meet specific requirements

• Associate degree or equivalent experience, i.e healthcare industry experience.

40

$21.10 - $44.99

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We anticipate the application window for this opening will close on: 07/22/2026