Description

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

Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes.

• Telephonic clinical case management with Medicare population.
• Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs.
• Completes a Comprehensive Assessment and Plan of care.
• Will document in clinical systems to support legacy Aetna and Coventry membership.
• Provides BH consultation and collaboration with Aetna partners.
• Active participation in clinical treatment rounds.
• Active participation in team activities focused on program development. Innovative thinking expected.
• The majority of time is spent at a desk on telephonic member outreaches and computer documentation.
• Assist members with locating community based behavioral health resources.

Required Qualifications

• 3+ years of direct clinical practice experience
• An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC, LISW, LSW)
• Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service
• Bilingual Spanish and English

Preferred Qualifications

• Crisis intervention skills preferred
• Managed care/utilization review experience preferred
• Case management and discharge planning experience preferred
• Discharge planning experience
• Utilization review, prior authorization, concurrent review, appeals experience
• CCM preferred
• DSNP experience a plus
• Knowledge of Substance Abuse Disorders

Education

• Masters Degree in Social Work or Counseling required

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $116,760.00

This 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 people

We 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 11/28/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.