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Position Summary

The Clinical Case Manager (CCM), Behavioral Health, is a work from home field-based role with up to 40% travel within Orange, Osceola, Seminole and Brevard counties. The CCM administers processes to coordinate and facilitate comprehensive care for a homeless Medicaid population with Serious Mental Illness and/or Substance Abuse Disorder.

Job Responsibilities

• Enroll eligible members with severe mental illness and/or substance use disorder into the housing pilot program and connect them with housing providers and community resources to meet their needs with the goal of offering permanency-related housing supports to members to break the cycle of chronic homelessness.

• Facilitate comprehensive behavioral health and/or medical care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers.

• Serve as an advocate for members ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.

• Partner, support, and collaborate with Florida State and local housing authorities and leverage these relationships with county housing programs and initiatives to better support the unique needs of our Medicaid members with housing insecurities.

• Administers the care coordination plan to assess member needs and ensure seamless transitions between different care settings.

• Develops strategies to reduce risk factors and address complex clinical indicators that impact care planning and issue resolution.

• Perform crisis intervention with members experiencing a behavioral health crisis, refer to appropriate providers, and follows up to ensure members are receiving the appropriate services.

• Adapts clinical guidelines, standardized case management procedures, and regulatory standards to needs assessments to ensure appropriate administration of benefits.

• Works collaboratively with the members’ interdisciplinary care team.

• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

• Helps member actively and knowledgably participate with their provider in healthcare decision-making.

• Facilitates clinical hand offs during transitions of care.

• Reports to: Manager, Clinical Health Services

Required Qualifications

• Must reside in the Orlando area

• Licensed mental health professional with current unencumbered license in the state of FL: Licensed Mental Health Counselor (LMHC), Licensed Marriage & Family Therapist (LMFT), PsyD, or Licensed Clinical Social Worker (LCSW) or active RN licensure with psychiatric experience

• Willing and able to travel up to 40% of their time in the Orlando area including Orange, Osceola, Seminole and Brevard counties to visit members face to face

• 3+ years of direct clinical practice experience post master’s degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility

• 2+ years of experience managing members with serious mental illness or substance use history

• 2+ years of experience using crisis intervention skills

• 2+ years of experience providing care to a diverse population

• 2+ years of experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)

Preferred Qualifications

• Bilingual Spanish

• Experience in assisting members with disabilities to secure accessible, affordable housing through Federal (such as HUD, Shelter Plus Care, SAMHSA, and USDA), as well as local programs

• Managed care/utilization review experience

• Case management and discharge planning experience

Education

• Minimum Master’s degree in behavioral/mental health/nursing or related field required

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)

We anticipate the application window for this opening will close on: 03/01/2025

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

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

We are an equal opportunity and affirmative action employer. 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.