Experienced Clinical Case Manager for Behavioral Health - Miami, FL: Transforming Lives through Comprehensive Care Management

Join Our Mission to Bring Heart to Healthcare

At CVS Health, our purpose is clear: we're dedicated to bringing our heart to every moment of your health. As a leader in the healthcare industry, we're committed to delivering enhanced, human-centric health care that's both personal and convenient. Our Heart At Work Behaviors guide our actions, ensuring that we empower our colleagues to transform our culture and drive innovation. We're seeking a compassionate and skilled Clinical Case Manager for Behavioral Health to join our team in Miami, FL, and make a meaningful difference in the lives of our members.

About the Role

As a Clinical Case Manager, Behavioral Health, you'll play a vital role in driving care management and coordination activities for our Seriously Mentally Ill (SMI) population. This field-based role requires up to 40% travel within Miami-Dade and Monroe counties, allowing you to make a tangible impact on our members' lives. You'll utilize your advanced clinical judgment and critical thinking skills to facilitate effective care planning, collaboration with providers, and coordination of psychosocial services.

Key Responsibilities

• Conduct telephonic and face-to-face assessments to identify member needs and develop personalized care plans.
• Collaborate with healthcare providers, family members, and other stakeholders to ensure comprehensive care coordination.
• Utilize clinical tools and data review to inform care planning and identify opportunities for improvement.
• Perform crisis intervention and provide follow-up support to members experiencing behavioral health crises.
• Apply clinical guidelines, criteria, and regulatory standards to ensure appropriate benefit administration.
• Serve as a single point of contact for members, addressing immediate and acute gaps in care and access.
• Present cases at conferences and rounds to obtain multidisciplinary input and achieve optimal outcomes.
• Work collaboratively with interdisciplinary care teams to drive member-centered care.
• Identify and escalate quality of care issues through established channels.
• Utilize influencing and motivational interviewing skills to empower members to make informed healthcare decisions.
• Develop and monitor plans of care to meet member goals, in collaboration with the care team.
• Facilitate clinical hand-offs during transitions of care to ensure continuity.

Essential Qualifications

• Bilingual in Spanish (required).
• Residency in the Miami area (required).
• Willingness to travel up to 40% within Miami-Dade and Monroe counties (required).
• 3+ years of direct clinical practice experience post-master's degree.
• 2+ years of experience managing members with serious mental illness.
• 2+ years of experience using crisis intervention skills.
• 2+ years of experience providing care to diverse populations.
• 2+ years of experience using personal computers, navigating multiple systems, and MS Office Suite applications.
• Licensed mental health professional with a current, unencumbered license in FL (LMHC, LMFT, PsyD, or LCSW).
• Master's degree in behavioral/mental health or a related field.

Preferred Qualifications

• Managed care/utilization review experience.
• Case management and discharge planning experience.

What We Offer

At CVS Health, we believe that our colleagues are our greatest asset. We offer a comprehensive benefits package, including:

• Competitive salary ($54,095.60 - $116,760.80).
• CVS Health bonus, commission, or short-term incentive programs.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Fully-paid term life insurance and short-term and long-term disability benefits.
• Well-being programs, education assistance, and free development courses.
• CVS store discount and discount programs with participating partners.
• Paid Time Off (PTO) and paid holidays.

Career Growth and Development

At CVS Health, we're committed to the growth and development of our colleagues. As a Clinical Case Manager, you'll have opportunities to:

• Develop advanced clinical skills through training and mentorship.
• Collaborate with interdisciplinary teams to drive innovative care solutions.
• Participate in case conferences and rounds to share expertise and best practices.
• Stay up-to-date with industry trends and regulatory changes through ongoing education and training.

Our Culture

At CVS Health, we're dedicated to creating a culture that values diversity, equity, and inclusion. We believe that our differences are our greatest strength, and we're committed to fostering an environment that's inclusive and supportive. As a colleague, you'll be part of a team that shares our purpose and is passionate about making a difference in the lives of our members.

Join Our Team

If you're a compassionate and skilled Clinical Case Manager looking to make a meaningful impact, we encourage you to apply. Our ideal candidate is passionate about delivering high-quality care, collaborating with interdisciplinary teams, and driving innovative solutions. If you're ready to join a team that's dedicated to bringing heart to healthcare, apply now!

We anticipate the application window for this opening will close on January 4, 2025. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.

CVS Health is an equal opportunity employer, committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. We strive to provide equal access to the benefits and privileges of employment, including the provision of reasonable accommodations to perform essential job functions.

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