At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary New Hire bonus potential up to $10,000 for eligible external candidates who possess NJ Choice Certification. Clinical Case Manager - Behavioral Health (MLTSS/D-SNP)
Location: Bergen County, NJ (50-75% local travel required)Position Summary:
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We are seeking a dedicated Clinical Case Manager - Behavioral Health to develop, implement, and support health service strategies, policies, and programs that ensure the delivery of high-quality, cost-effective care to our members. This role requires advanced clinical judgment and critical thinking to coordinate physical, behavioral, and psychosocial services that support member wellness and independence.Key Responsibilities:
- Design and execute care strategies aligned with utilization management, quality improvement, network management, and clinical policy.
- Conduct comprehensive, face-to-face assessments for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE).
- Evaluate member needs and coordinate services such as adult/pediatric medical daycare, personal care assistance, nursing facility placement, and MLTSS enrollment.
- Collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams to develop and implement individualized care plans.
- Authorize services within the MLTSS/FIDE benefit structure and connect members with appropriate community resources.
- Accurately document all interactions and care plans in the electronic health record in a timely manner.
- Participate in interdisciplinary team meetings and advocate for member needs.
- Mentor new hires upon reaching proficiency in the role.
- Must reside in Bergen County, NJ.
- Active NJ license as a Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW).
- Minimum of 2 years of behavioral health experience.
- Ability and willingness to travel 50-75% within Bergen County and surrounding areas (mileage reimbursed).
- Reliable transportation required.
- Successful completion of NJ Choice Certification (including an exam score of 80%+, state training modules, and field mentoring) is a condition of employment.
- Experience in case management and/or discharge planning.
- Background in managed care settings.
- Strong crisis intervention and problem-solving skills.
- Proficiency in Microsoft Office Suite and ability to navigate multiple systems.
- Master's degree in Social Work or a related behavioral health field is required.
40Time Type
Full timePay Range
The typical pay range for this role is:$72,627.00 - $155,538.00This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.