Clinical Case Manager, Behavioral Health

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. Position Summary The 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. Mercy 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, Arizona’s Medicaid agency, and deliver services throughout the state. Mercy 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. Primary Responsibilities General Utilize clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program. Apply 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. Evaluation of Members Through the use of care management tools and information/data review, conduct comprehensiv...