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Clinical Case Manager Behavioral Health Maricopa County
CVS Health Phoenix, AZ
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$86k-103k (estimate)
Full Time | Ancillary Healthcare 0 Months Ago
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CVS Health is Hiring a Clinical Case Manager Behavioral Health Maricopa County Near Phoenix, AZ

Job Description
Mercy Care is a not-for-profit Medicaid managed-care health plan, serving Arizonans since 1985. We provide access to physical and behavioral health care services, to people who are eligible for Medicaid. Our members include families, children, seniors, and individuals who have developmental/cognitive disabilities. We hold multiple contracts with AHCCCS, Arizona’s Medicaid agency, and deliver services throughout the state.

Mercy Care is administered by Aetna, a CVS Health company. Our staff is employed by Aetna and CVS Health. This gives Mercy Care the resources of a national organization, and still allows us to bring our members the familiarity and presence of a local team of people who put our members at the center of everything we do.
The Clinical Case Manager BH is a full time telework position that requires some travel.
This position is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.
At Mercy Care, our vision is for our members to live their healthiest lives and achieve their full potential. We’re a local company, serving Arizonans of all ages who are eligible for Medicaid since 1985. We also serve people who are eligible for both Medicaid and Medicare. Mercy Care is sponsored by Dignity Health and Ascension Health and is administered by Aetna, a CVS Health Business. In April 2021 we’re going to begin delivering integrated physical and behavioral health services to children involved with the child welfare system, in a unique partnership with the Arizona Department of Child Safety and their Comprehensive Health Plan. We value diversity, compassion, innovation, collaboration and advocacy. If your values are the same as ours, let’s work together to make a difference and improve the health and wellbeing of Arizona.
This position requires the ability to travel in state with a personal vehicle up to 10% of the time. Qualified candidates must have a valid AZ driver's license, reliable transportation, and proof of vehicle insurance.
Flexibility to work beyond the core business hours of Monday-Friday, 8am-5pm, is required. We are serving the needs of children and families that may require meeting after school, after work, etc.
Fundamental Components:
Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member’s level of work capacity and related restrictions/limitations.
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
• Works in a typical office working environment with productivity and quality expectations.
• Work requires the ability to perform close inspection of handwritten and computer-generated documents.
• Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
• Multitasks, prioritizes and effectively adapts to a fast-paced changing environment.
• Demonstrates effective communication skills, both verbal and written.
Pay Range
The typical pay range for this role is:
Minimum: 58,760
Maximum: 125,840
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
- Masters prepared behavioral health clinician with current unrestricted state licensure required (LCSW, LMSW, LPC, LAC, LMFT, LAMFT).
-5 years’ clinical practice experience.
-3 years' Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.
-Must reside in Maricopa County or close to it to be able to see Maricopa County members for face-to-face visits
Preferred Qualifications
Case Management experience in an integrated model preferred.
Education
Masters degree in behavioral health field 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.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ancillary Healthcare

SALARY

$86k-103k (estimate)

POST DATE

03/17/2023

EXPIRATION DATE

06/27/2023

WEBSITE

cvshealth.com

HEADQUARTERS

WOONSOCKET, RI

SIZE

>50,000

FOUNDED

1963

TYPE

Public

CEO

KAREN S LYNCH

INDUSTRY

Ancillary Healthcare

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CVS Health owns and operates a chain of pharmacies and clinics.

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