SIGNON BONUS $5,000 FOR EXTERNAL APPLICANTS.

***Remote, Work From Home Flexible, Field Based Position***

This position requires the ability to travel in the Chicago area, up to 75% of the time.

Core business hours for this position are 8 am to 5 pm CST.

As part of the care coordination team, the ACO REACH Clinical Case Manager BH will function as both a primary care manager for a selected member population and also act as a SME to collaborate with RN CMs when assistance with psychosocial issues and community resources are required.

The Clinical Case Manager BH is responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members across the continuum of care. The Clinical Case Manager BH utilizes advance clinical judgement and critical thinking skills to effectively manage members through their illness with the goal of assuring the appropriate level of care is being provided, preventing Emergency Department visits and acute admissions, and ensuring the members physical, behavioral and social needs are being appropriately addressed by the care team to achieve optimal clinical, financial and quality of life outcomes.

Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators to manage the chronic conditions of members.

Primary responsibilities include but not limited to the following:

• Serve as primary care manager for members identified for the ACO REACH Program
• Engage members to complete a holistic assessment of current health status and work collaboratively with the care team to manage the member’s most difficult symptoms and adaptation to their ongoing decline
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Educate and assist member with advanced care planning, including establishing and end-of-life treatment plan
• Monitor and evaluate effectiveness of the care plan and modify plan in collaboration with multi-disciplinary team as necessary
• Work with treating physicians to develop anticipatory symptom management plan and monitor for new issues/concerns/changes in pace of illness
• Prepare member/caregiver to understand and identify signs of functional decline and discuss long term plan for managing to help avert medical emergencies
• Ensure safe and appropriate transitions of care by collaborating with hospital discharge planners, outpatient provider, family/caregivers and member, to ensure adequate caregiver assistance, functional support, medical follow up and medication oversight during transition from facility to home
• Make referrals to the Pharmacist for medication review and recommendations as indicated
• Make referrals to BH specialist as indicated

Pay Range
The typical pay range for this role is:
Minimum: 58,760
Maximum: 125,840

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• A LCSW must hold an unrestricted license in their state of residence, with multi-state/compact privileges and have the ability to be licensed in all non-compact states.
• 3+ years clinical experience
• Must reside in the state of Illinois, able to travel in Chicago area.
• Reliable transportation required
• Mileage is reimbursed per our company expense reimbursement policy

COVID Requirements

COVID-19 Vaccination Requirement
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.

Preferred Qualifications

• Excellent analytic and problem-solving skills
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Bilingual in Spanish and English preferred.

Education

• Completed Social Workers Master's Degree Program from

Accredited College or University

• Current and Active Clinical Social Worker State License in the state of Illinois

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.