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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.
Position Summary
*Fully remote. Work anywhere in the U.S.
*Schedule: Monday - Friday 8:00 AM - 5:00 PM (No nights, no weekends and no Holidays)
The Analyst, Care Planner Behavioral Health role provides comprehensive behavioral health care management support to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issues.
Additional Responsibilities Include but not limited to the following:
• Monitor referral task lists in multiple systems
• Log and assign new case management cases to Case managers across department
• Verify eligibility for case management by verifying member's insurance coverage
• Ensure applicable turn around times are met
• Provides support and service to behavioral health clinical teams in support of member engagement and care.
• Provides outreach to members to educate them about available specialty programs and to solicit their
participation.
• Educates members about available web-based resources.
• Under the direction of clinical management staff, conducts case management-related research and coordinates both
internal and external resources, assisting members with claim and benefits issue resolution, referrals to EAP,
referrals to legal and financial services, and referrals to community support services.
•Complete provider searches on behalf of members by searching and calling providers to check network status and availability
•Assist with special projects including but not limited to assisting with network deficiencies, completion of audit templates, coordination of flow control, etc
• Participates in designated team meetings with team members and clinical staff.
• Adheres to compliance and Patient Management policies and regulatory requirements.
• Maintains accurate and complete documentation of required information meeting risk management,
regulatory, and accreditation requirements.
• Participates in designated clinical quality management initiatives
Required Qualifications
2 years Behavioral Health care experience.
• Previous Customer Service experience.
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
Preferred Qualifications
Previous Managed Care experience.
• Psychology or Social Services experience.
• Bilingual
Education
Associates Degree OR equivalent combination of education and experience
Pay Range
The typical pay range for this role is:
$21.10 - $36.78This 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
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
United States
