Clinical Case Manager, Behavioral Health (West Valley, Arizona)

divh2Clinical Case Manager, Behavioral Health/h2pWere building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, youll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time./ph3Position Summary/h3pThe Clinical Case Manager, Behavioral Health is a full-time telework role, open to candidates located within Maricopa County, Arizona. This role will require up to 25-50% travel within West Valley, including member visits and office work./ppMercy Care is a not-for-profit Medicaid managed-care health plan, serving Arizonans since 1985. We provide access to physical and behavioral health care services, specifically to people who are eligible for Medicaid. Our members include families, children, seniors, and individuals who have developmental/cognitive disabilities. We hold multiple contracts with AHCCCS, Arizonas Medicaid agency, and deliver services throughout the state./ppMercy Care is administered by Aetna, a CVS Health company. Our staff is employed by Aetna and CVS Health. This gives Mercy Care the resources of a national organization, and still allows us to bring our members the familiarity and presence of a local team of people who put our members at the center of everything we do./ph3Primary Responsibilities/h3ulliGeneral ulliUtilize clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program./liliApply critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for members, specifically by providing care coordination, support, and member education through the use of care management tools and resources./li/ul/liliEvaluation of Members ulliThrough the use of care management tools and information/data review, conduct comprehensive evaluation of referred members needs/eligibility and recommend an approach to case resolution and/or meeting needs, particularly by evaluating members benefit plan, as well as available internal and external programs/services./liliIdentify high-risk factors and service needs that may impact member outcomes and care planning components with appropriate referrals./liliCoordinate and implement assigned care plan activities and monitor care plan progress./li/ul/liliEnhancement of Medical Appropriateness and Quality of Care ulliUse a holistic approach to overcome barriers to meet goals and objectives; present cases at case conferences to obtain multidisciplinary review, in order to achieve optimal outcomes./liliIdentify and escalate quality of care issues through established channels./liliUtilize negotiation skills to secure appropriate options and services necessary to meet the members benefits and/or healthcare needs./liliUtilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes, in order to achieve optimum level of health./liliProvide coaching, information, and support to empower the member to make ongoing, independent medical and/or healthy lifestyle choices./liliHelp members actively and knowledgably participate with their provider in healthcare decision-making./li/ul/liliMonitoring, Evaluation, and Documentation of Care ulliUtilize case management processes in compliance with regulatory and accreditation guidelines, as well as company policies and procedures./li/ul/li/ulh3Required Qualifications/h3ulliActive and good standing Arizona clinical and/or counseling license, specifically LPC (Licensed Professional Counselor), LAC (Licensed Associate Counselor), LMSW (Licensed Master Social Worker), LCSW (Licensed Clinical Social Worker), and/or LISAC (Licensed Independent Substance Abuse Counselor)./lili3+ years of direct clinical practice experience./lili2+ years of case management experience, specifically working with people who have been designated as having a serious mental illness (SMI), are elderly, or have a physical disability./liliMust reside in West Valley, Maricopa County, Arizona./liliWillingness to work Monday-Friday from 8am-5pm Arizona Time Zone./liliMust possess reliable transportation and be willing and able to travel up to 25-50% of the time within West Valley, Arizona, specifically to meet with members. Mileage is reimbursed per our company expense reimbursement policy./li/ulh3Preferred Qualifications/h3ulliProficient in Microsoft Suite, including Word, Excel, PowerPoint, Outlook, and Teams./liliStrong time management skills, organizational skill set, and ability to multitask./liliStrong customer service skills./liliExcellent communication skills, both verbal and written./liliAbility to quickly learn several operating systems for data entry and authorizations./liliPrevious experience collaborating with medical professionals./liliStrong team player./liliCrisis intervention skills./liliPrevious experience with managed care and utilization review./liliPrevious experience with discharge planning./li/ulh3Education/h3ulliMasters degree in behavioral/mental health, with active and good standing Arizona clinical counseling license, specifically LPC, LISAC, LCSW, LAC, and/or LMSW./li/ulh3Anticipated Weekly Hours/h3p40/ph3Time Type/h3pFull time/ph3Pay Range/h3pThe typical pay range for this role is:/pp$60,522.00 - $129,615.00/ppThis 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./ppOur people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong./ppGreat benefits for great people/ppWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families./ppThis full?time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well?being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility./ppAdditional details about available benefits are provided during the application process and on Benefits Moments./ppWe anticipate the application window for this opening will close on: 05/25/2026/ppQualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws./p/div