Behavioral Health Clinical Case Manager- Eastern Mountain Region

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.

Field Based- 50% of the time throughout the Eastern Mountain Region of Kentucky (includes counties: Breathitt, Floyd, Johnson, Knott, Lee, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike, Wolfe)

Monday-Friday 8am-5pm (must be flexible with schedule due to nature of the role and travel)

Applies advanced clinical judgement to facilitate appropriate member physical health and behavioral healthcare. Implements strategy to assess and plan care, direct provider collaboration, and coordinate psychosocial wraparound services. Instructs the application of available resources to produce optimal, cost-effective outcomes.

• Conduct behavioral health and psychosocial assessments.
• Develop, implement, and monitor individualized care plans.
• Coordinate services across behavioral health, medical, and community providers.
• Support discharge planning and transitions of care.
• Advocate for members and connect them to community resources.
• Monitor member progress, identify barriers, and facilitate problem-solving to improve outcomes.
• Participate in interdisciplinary care team meetings and provider collaboration.

• Active, unrestricted licensure as an LCSW, LPC, LMFT, Psychologist, or other qualified behavioral health professional in accordance with state requirements.
• Masters degree in Social Work, Counseling, Psychology, Human Services, or a related field
• Minimum of three (3) years of experience in behavioral health, case management, care coordination, or a related setting.
• Experience conducting behavioral health assessments and developing member-centered care plans.
• Knowledge of mental health, substance use disorders, trauma-informed care, recovery principles, and community-based services.
• Experience coordinating care across providers, families, community agencies, and other service systems.
• Strong communication, clinical judgment, documentation, and organizational skills.
• Ability to manage complex cases and support members with behavioral health and psychosocial needs.
• Proficiency with electronic health records and care management systems.
• Must reside in the Eastern Mountain Region of Kentucky (includes following counties: Breathitt, Floyd, Johnson, Knott, Lee, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike, Wolfe)

• Experience in Medicaid managed care, community mental health, child welfare, or foster care populations.
• Experience working with members with serious mental illness (SMI), serious emotional disturbance (SED), substance use disorders (SUD), or co-occurring conditions.
• Case Management Certification (CCM) or related certification.

Masters degree in Social Work, Counseling, Psychology, Human Services, or a related behavioral health field required

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
• A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
• Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
• The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
• If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

• Device & System Navigation:
  Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
• Communication Tools:
  Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and…