Behavioral Health Clinical Case Manager- Eastern Mountain Region

Applies advanced clinical judgement to facilitate appropriate member physical health and behavioral healthcare. Implements strategy to assess and plan care, direct provider collaboration, and coordinate psychosocial wraparound services. Instructs the application of available resources to produce optimal, cost-effective outcomes. Field based 50% of the time throughout the Eastern Mountain Region of Kentucky; Monday-Friday 8am-5pm (must be flexible with schedule due to nature of the role and travel). Anticipated weekly hours: 40.

Responsibilities

Conduct behavioral health and psychosocial assessments; Develop, implement, and monitor individualized care plans; Coordinate services across behavioral health, medical, and community providers; Support discharge planning and transitions of care; Advocate for members and connect them to community resources; Monitor member progress, identify barriers, and facilitate problem-solving to improve outcomes; Participate in interdisciplinary care team meetings and provider collaboration

Requirements

Active, unrestricted licensure as an LCSW, LPC, LMFT, Psychologist, or other qualified behavioral health professional in accordance with state requirements; Masters degree in Social Work, Counseling, Psychology, Human Services, or a related field; Minimum of three (3) years of experience in behavioral health, case management, care coordination, or a related setting; Experience conducting behavioral health assessments and developing member-centered care plans; Knowledge of mental health, substance use disorders, trauma-informed care, recovery principles, and community-based services; Experience coordinating care across providers, families, community agencies, and other service systems; Strong communication, clinical judgment, documentation, and organizational skills; Ability to manage complex cases and support members with behavioral health and psychosocial needs; Proficiency with electronic health records and care management systems; Must reside in the Eastern Mountain Region of Kentucky (Breathitt, Floyd, Johnson, Knott, Lee, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike, Wolfe counties); Comfortable setting up and using multiple monitors and navigating multiple applications; Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings; Experience with Microsoft Office 365 or similar (Google Workspace); Ability to log in to secure systems (e.g., VPN, EHR portal) and recognize suspicious emails or links; Ability to resolve common technical issues independently and contact IT when needed; Direct/hardwired internet connection with minimum 25 Mbps download and 3 Mbps upload (WiFi and satellite not permitted); Quiet, secure, private home workspace compliant with CVS Health and HIPAA guidelines

Nice to have

Experience in Medicaid managed care, community mental health, child welfare, or foster care populations; Experience working with members with serious mental illness (SMI), serious emotional disturbance (SED), substance use disorders (SUD), or co-occurring conditions; Case Management Certification (CCM) or related certification

Benefits

Medical, dental, and vision coverage; Paid time off; Retirement savings options; Wellness programs; Other resources based on eligibility; Eligible for CVS Health bonus, commission or short-term incentive program