Clinical Case Manager, Behavioral Health

This is a fully remote position, open to applicants in New York.

📋 Description

• Perform thorough psychosocial, behavioral health, and care management evaluations.

• Create, execute, oversee, and revise personalized care plans.

• Coordinate behavioral health, medical, pharmacy, and social support services with various providers and environments.

• Recognize and tackle barriers to care, such as housing instability, food insecurity, transportation challenges, and insufficient social support.

• Facilitate referrals and connections to community resources, behavioral health services, HCBS programs, and supportive services.

• Track member progress through outreach, care plan assessments, and interdisciplinary case discussions.

• Coordinate care transitions following hospital stays, psychiatric admissions, skilled nursing facility visits, emergency room visits, and rehabilitation services.

• Provide crisis intervention assistance and promote behavioral health referrals.

• Advocate for recovery-oriented, trauma-informed, and culturally sensitive care.

• Collaborate with psychiatrists, therapists, primary care providers, care management teams, and community partners.

• Educate members and their caregivers about treatment plans, medication adherence, self-management, and available resources.

• Identify care gaps and implement strategies to enhance member outcomes and quality metrics.

• Engage in interdisciplinary team meetings, utilization reviews, and case conferences.

• Ensure timely and precise documentation in alignment with organizational, state, federal, Medicaid, Medicare, and accreditation standards.

• Complete necessary assessments, care plans, outreach tasks, and regulatory documentation within set deadlines.

• Manage a caseload of members with diverse levels of behavioral and medical complexity.

⛳️ Requirements

• Must hold a license in New York as LMSW or LCSW.

• Work schedule: Monday–Friday, 08:30 AM–05:00 PM EST.

• At least 3 years of experience in behavioral health, care management, case management, social work, managed care, health home, or a related healthcare environment.

• Experience with adults facing serious mental illness, substance use disorders, and co-occurring behavioral and physical health issues.

• Required experience working with Medicaid and/or Medicare populations.

• Proven experience in coordinating services across behavioral health, medical, long-term care, and community-based settings.

• A Master's Degree in Social Work (MSW) from an accredited institution is mandatory.

• Current New York State Licensed Master Social Worker (LMSW) is required.

• Strong knowledge of behavioral health diagnoses, treatment methods, and recovery principles.

• Familiarity with Medicaid, Medicare, Managed Care, and behavioral health regulations.

• Knowledge of serious mental illnesses, substance use disorders, crisis intervention, and trauma-informed care practices.

• Exceptional assessment, care coordination, and care planning abilities.

• Strong clinical judgment and critical-thinking skills.

• Capability to effectively engage members with intricate psychosocial and behavioral health requirements.

• Excellent communication, motivational interviewing, and relationship-building capabilities.

• Ability to work autonomously and manage a high-volume caseload.

• Proficient in electronic medical records and care management systems.

• Strong organizational skills and meticulous attention to detail.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base salary range.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Paid time off.

• Retirement savings options.

• Wellness initiatives.

• Additional resources supporting physical, emotional, and financial well-being, based on eligibility.