5K New Hire Bonus! Case Manager Behavioral Health (Field - Chinatown area) Bilingual Preferred

Position Summary We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll 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. Up to $5,000 New Hire Bonus Available! Help us elevate our patient care to a whole new level. Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life‑changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Responsibilities Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develop and implement health strategies, tactics, policies and programs that ensure the delivery of benefits and establish overall member wellness and timely return to work. Our Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost‑effective outcomes. Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate. Implements and coordinates all case‑management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case‑management services. Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determine eligibility for benefits as appropriate. Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person. Prepares all required documentation of case work activities as appropriate. Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes. May make outreach to treating physician or specialists concerning course of care and treatment as appropriate. Provides educational and prevention information for best medical outcomes. Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. Utilizes case‑management processes in compliance with regulatory and company policies and procedures. Facilitates appropriate condition management, optimizes overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work. Develops a proactive course of action to address issues presented to enhance the short and long‑term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration. Monitors member/client progress toward desired outcomes through assessment and evaluation. Required Qualifications Minimum 3‑5 years clinical practical experience. Minimum 2‑3 years CM, discharge planning and/or home health care coordination experience. Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually. Must possess reliable transportation and be willing and able to travel up to 75% of the time in the South loop, Chinatown and surrounding areas. Mileage is reimbursed per company expense reimbursement policy. Excellent analytical and problem‑solving skills. Effective communication, organizational, and interpersonal skills. Ability to work independently. Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some proprietary applications. Preferred Qualifications Certified Case Manager is preferred. Cantonese and Mandarin speaking preferred. Education & Licenses Master’s Degree in Behavioral/Mental Health or related field. LCSW or LCPC in the state of Illinois. Pay and Benefits Annual salary to be determined based on experience, location, and other factors. Eligible for CVS Health bonus, commission or short‑term incentive program in addition to base pay. Offers comprehensive benefits package including medical, dental, vision, paid time off, retirement savings options, wellness programs, and other resources. Employment Details Full‑time, 40 hours per week. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Application Closure Application window will close on 05/29/2026. #J-18808-Ljbffr 4004 Aetna Medicaid Administrators