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Clinical Case Manager Behavioral Health - Job Opportunity at CVS Health

Burlington, United States
Full-time
Mid-level
Posted: March 1, 2025
Hybrid
USD 72,627 - 155,538 per year

Benefits

Comprehensive medical, dental, and vision coverage with competitive market rates
401(k) retirement plan with employer matching
Employee Stock Purchase Plan enabling direct company investment
Fully-paid term life insurance coverage
Short and long-term disability protection
Flexible Paid Time Off (PTO) program with paid holidays
Professional development support and education assistance
Employee wellness programs and resources
CVS retail store discount program
Partner discount programs across multiple vendors

Key Responsibilities

Lead face-to-face comprehensive assessments for MLTSS and D-SNP program members
Develop and manage individualized care plans coordinating multiple healthcare providers
Evaluate and authorize medical service requests including daycare and nursing facilities
Coordinate cross-functional care teams and advocate for member needs
Maintain detailed electronic health records and documentation
Mentor new team members and provide training support
Manage 50-75% travel schedule across assigned counties

Requirements

Education

Master's Degree in Social or Behavioral Health field required

Experience

2+ years Behavioral Health experience/expertise

Required Skills

Licensed Clinical Social Worker or Licensed Social Worker in NJ Crisis intervention skills Computer proficiency and multi-system navigation MS Office Suite applications proficiency Care management and discharge planning expertise Managed Care experience

Certifications

NJ Choice Certification (required post-hire) Valid NJ Social Work License
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Sauge AI Market Intelligence

Industry Trends

Growing emphasis on integrated behavioral health and medical care management in response to rising mental health concerns and complex care needs Increased focus on home-based and community care services as alternatives to institutional care Expansion of managed care programs for dual-eligible populations reflecting healthcare policy shifts Rising demand for behavioral health professionals with care coordination expertise due to healthcare integration initiatives

Salary Evaluation

The offered salary range is competitive for the region and role, with the upper range reflecting senior-level expertise. Market data suggests this range aligns with similar roles at major healthcare organizations.

Role Significance

Typically part of a 10-15 person care management team with matrix reporting to clinical and administrative leadership
Mid to senior-level position with significant autonomy in care planning and resource allocation

Key Projects

Implementation of integrated care models for complex behavioral health populations Development of community-based care coordination programs Quality improvement initiatives for care management outcomes Member advocacy and care access enhancement projects

Success Factors

Strong clinical assessment and care planning capabilities combined with knowledge of community resources Excellent interpersonal skills for building relationships with members, families, and healthcare providers Ability to navigate complex healthcare systems while maintaining compliance with regulatory requirements Effective time management skills balancing field work with documentation responsibilities

Market Demand

High demand with sustained growth projected due to aging population and expanded behavioral health coverage mandates

Important Skills

Critical Skills

Clinical assessment and care planning expertise essential for effective member outcomes Knowledge of NJ healthcare systems and community resources critical for service coordination Documentation and regulatory compliance skills necessary for program requirements

Beneficial Skills

Experience with value-based care models Knowledge of population health management principles Cultural competency and diversity awareness Quality improvement methodologies

Unique Aspects

Integration of behavioral health with managed long-term care services
Combination of field-based work with telehealth capabilities
Direct impact on community health outcomes through service coordination
Opportunity to influence healthcare delivery models in evolving managed care landscape

Career Growth

Typical progression to team lead or program manager roles within 2-3 years, with potential for director-level positions in 5-7 years

Potential Next Roles

Clinical Team Lead Care Management Program Manager Regional Care Management Director Quality Improvement Manager

Company Overview

CVS Health

CVS Health is a leading integrated healthcare company combining retail pharmacy, health insurance, and healthcare services

Fortune 5 company with significant market influence in healthcare delivery and insurance markets
Strong presence in New Jersey market with established networks and community partnerships
Professional healthcare environment with emphasis on clinical excellence and member-centered care
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