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Overview
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. Work Arrangement
Fully remote Standard business hours—one late day until 7 pm your local time. No holidays. Core Responsibilities
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. Assessment of Members —through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Clinical Judgment & Crisis Intervention —applies clinical judgment to reduce risk factors and address complex clinical indicators, performs crisis intervention with members experiencing behavioral health or medical crisis, refers them to the appropriate clinical providers, and provides crisis follow‑up. Medical Appropriateness & Quality of Care —applies and interprets criteria and clinical guidelines, standardized case management plans, policies, procedures and regulatory standards while assessing benefits and member needs; consults with supervisors, medical directors and other programs to overcome barriers and present cases at multidisciplinary conferences. Identifies and escalates quality of care issues; influences medical and behavioral health professionals; utilizes motivational interviewing skills to ensure maximum member engagement and promotes lifestyle changes. Provides coaching, information and support to empower members to make ongoing independent medical and/or healthy lifestyle choices; helps them actively participate in healthcare decision‑making. Analyzes utilization, self‑report and clinical data to identify comprehensive member needs; develops and monitors plans of care; uses case management and quality management processes in compliance with regulatory and accreditation guidelines. Required Qualifications
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. Knowledge of mental health and substance abuse disorders. Must be able to talk on the telephone and type at the same time. Experience using Motivational Interviewing and good technological skills. One of the following licenses must be INDEPENDENTLY ACTIVE, UNRESTRICTED behavioral health and unencumbered in the state where they work: LCSW Licensed Clinical Social Worker, LSW Licensed Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LPC Licensed Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor, LCMHC Licensed Clinical Mental Health Counselor. Education
Master’s degree in behavioral health field required. Hours & Pay
Anticipated Weekly Hours : 40 Time Type : Full time Pay Range : $60,522.00 – $129,615.00 (base hourly or base annual full‑time salary; actual base salary may vary with experience, education, geography and other factors). Eligible for CVS Health bonus, commission or short‑term incentive program. Benefits
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. In addition to competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including company matching), 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 . Application Window
We anticipate the application window for this opening will close on: 01/06/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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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. Work Arrangement
Fully remote Standard business hours—one late day until 7 pm your local time. No holidays. Core Responsibilities
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. Assessment of Members —through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Clinical Judgment & Crisis Intervention —applies clinical judgment to reduce risk factors and address complex clinical indicators, performs crisis intervention with members experiencing behavioral health or medical crisis, refers them to the appropriate clinical providers, and provides crisis follow‑up. Medical Appropriateness & Quality of Care —applies and interprets criteria and clinical guidelines, standardized case management plans, policies, procedures and regulatory standards while assessing benefits and member needs; consults with supervisors, medical directors and other programs to overcome barriers and present cases at multidisciplinary conferences. Identifies and escalates quality of care issues; influences medical and behavioral health professionals; utilizes motivational interviewing skills to ensure maximum member engagement and promotes lifestyle changes. Provides coaching, information and support to empower members to make ongoing independent medical and/or healthy lifestyle choices; helps them actively participate in healthcare decision‑making. Analyzes utilization, self‑report and clinical data to identify comprehensive member needs; develops and monitors plans of care; uses case management and quality management processes in compliance with regulatory and accreditation guidelines. Required Qualifications
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. Knowledge of mental health and substance abuse disorders. Must be able to talk on the telephone and type at the same time. Experience using Motivational Interviewing and good technological skills. One of the following licenses must be INDEPENDENTLY ACTIVE, UNRESTRICTED behavioral health and unencumbered in the state where they work: LCSW Licensed Clinical Social Worker, LSW Licensed Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LPC Licensed Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor, LCMHC Licensed Clinical Mental Health Counselor. Education
Master’s degree in behavioral health field required. Hours & Pay
Anticipated Weekly Hours : 40 Time Type : Full time Pay Range : $60,522.00 – $129,615.00 (base hourly or base annual full‑time salary; actual base salary may vary with experience, education, geography and other factors). Eligible for CVS Health bonus, commission or short‑term incentive program. Benefits
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. In addition to competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including company matching), 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 . Application Window
We anticipate the application window for this opening will close on: 01/06/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr