Clinical Counselor jobs at CVS Health

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. ***Fully remote*** **Standard business hours.** **1 late day until 7pm your local time.** **No holidays.** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members: Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. - Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow-up to members to help ensure they are receiving the appropriate treatment/services. Enhancement of Medical Appropriateness and Quality of Care: - Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits - Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels - Ability to speak to medical and behavioral health professionals to influence appropriate member care. - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. - Helps member actively and knowledgably participate with their provider in healthcare decision-making - Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. Monitoring, Evaluation and Documentation of Care: - In collaboration with the member and their care team develops and monitors established plans of care to meet the member's goals - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Must be able to multitask Required qualifications: + 3 years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility + Requires knowledge of mental health and substance abuse disorders . + Must be able to talk on the telephone and type at the same time. + Experience using Motivational Interviewing and good technological skills + One of the following license must be INDEPENDENTLY ACTIVE, UNRESTRICTED behavioral health Unencumbered in the state where they work. One of the following: LCSW Licensed Clinical Social Worker LSW Licensed Social Worker LISW Licensed Independent Social Worker LCPC Licensed Clinical Professional Counselor LPC Licensed Professional Counselor LP Licensed Psychologist LMFT Licensed Marriage and Family Therapist LMHC Licensed Mental Health Counselor LCMHC Licensed Clinical Mental Health Counselor Education: Master's degree in behavioral health field required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $60,522.00 - $129,615.00 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/20/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryFully remote in the USA; Shift Monday through Friday standard business hours, 8am to 5pm. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psycho social wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members:Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. Required Qualifications3 years of direct clinical practice experience post master's degree, e. g. , hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility3 years required knowledge of mental health and substance abuse disorders 3 years experience, must be able to talk on the telephone and type at the same time3 years experience using Motivational Interviewing and good technological skills Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required:(LCSW Licensed Clinical Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) Must be willing and able to work Monday through Friday, 8:00am to 5:00pm in time zone of residence Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred Managed care/utilization review experience preferred EducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryFully remote in the USA; Shift Monday through Friday standard business hours, 8am to 5pm. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psycho social wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members:Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. Required Qualifications3 years of direct clinical practice experience post master's degree, e. g. , hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility3 years required knowledge of mental health and substance abuse disorders 3 years experience, must be able to talk on the telephone and type at the same time3 years experience using Motivational Interviewing and good technological skills Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required:(LCSW Licensed Clinical Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) Must be willing and able to work Monday through Friday, 8:00am to 5:00pm in time zone of residence Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred Managed care/utilization review experience preferred EducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. *Fully remote*Standard business hours. 1 late day until 7pm your local time. No holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members: Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. • Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. • Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow-up to members to help ensure they are receiving the appropriate treatment/services. Enhancement of Medical Appropriateness and Quality of Care:• Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits• Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes• Identifies and escalates quality of care issues through established channels • Ability to speak to medical and behavioral health professionals to influence appropriate member care. • Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. • Helps member actively and knowledgably participate with their provider in healthcare decision-making• Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. Monitoring, Evaluation and Documentation of Care:• In collaboration with the member and their care team develops and monitors established plans of care to meet the member's goals• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Must be able to multitask Required qualifications:3 years of direct clinical practice experience post master's degree, e. g. , hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility Requires knowledge of mental health and substance abuse disorders . Must be able to talk on the telephone and type at the same time. Experience using Motivational Interviewing and good technological skills One of the following license must be INDEPENDENTLY ACTIVE, UNRESTRICTED behavioral health Unencumbered in the state where they work. One of the following: LCSW Licensed Clinical Social Worker LSW Licensed Social Worker LISW Licensed Independent Social Worker LCPC Licensed Clinical Professional Counselor LPC Licensed Professional Counselor LP Licensed Psychologist LMFT Licensed Marriage and Family Therapist LMHC Licensed Mental Health Counselor LCMHC Licensed Clinical Mental Health CounselorEducation: Master's degree in behavioral health field required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/20/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryFully remote in the USA; Shift Monday through Friday standard business hours, 8am to 5pm. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psycho social wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members:Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. Required Qualifications3 years of direct clinical practice experience post master's degree, e. g. , hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility3 years required knowledge of mental health and substance abuse disorders 3 years experience, must be able to talk on the telephone and type at the same time3 years experience using Motivational Interviewing and good technological skills Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required:(LCSW Licensed Clinical Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) Must be willing and able to work Monday through Friday, 8:00am to 5:00pm in time zone of residence Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred Managed care/utilization review experience preferred EducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryUtilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Telephonic clinical case management with Medicare population. Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs. Completes a Comprehensive Assessment and Plan of care. Will document in clinical systems to support legacy Aetna and Coventry membership. Provides BH consultation and collaboration with Aetna partners. Active participation in clinical treatment rounds. Active participation in team activities focused on program development. Innovative thinking expected. The majority of time is spent at a desk on telephonic member outreaches and computer documentation. Assist members with locating community based behavioral health resources. Required Qualifications3+ years of direct clinical practice experience An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC, LISW, LSW) Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service Bilingual Spanish and English Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred Discharge planning experience Utilization review, prior authorization, concurrent review, appeals experience CCM preferred DSNP experience a plus Knowledge of Substance Abuse DisordersEducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$54,095. 00 - $116,760. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 11/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. + Telephonic clinical case management with Medicare population. + Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs. + Completes a Comprehensive Assessment and Plan of care. + Will document in clinical systems to support legacy Aetna and Coventry membership. + Provides BH consultation and collaboration with Aetna partners. + Active participation in clinical treatment rounds. + Active participation in team activities focused on program development. Innovative thinking expected. + The majority of time is spent at a desk on telephonic member outreaches and computer documentation. + Assist members with locating community based behavioral health resources. **Required Qualifications** + 3+ years of direct clinical practice experience + An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC, LISW, LSW) + Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service + Bilingual Spanish and English **Preferred Qualifications** + Crisis intervention skills preferred + Managed care/utilization review experience preferred + Case management and discharge planning experience preferred + Discharge planning experience + Utilization review, prior authorization, concurrent review, appeals experience + CCM preferred + DSNP experience a plus + Knowledge of Substance Abuse Disorders **Education** + Masters Degree in Social Work or Counseling required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $116,760.00 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 11/28/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. Under the direction of the Lead Director, Service Operations, this position will focus on utilization, quality and fraud waste and abuse review for individual cases for members across Aetna . This role is fully remote. Eligible candidates must be licensed in Arizona and live in the greater Phoenix area. Expectations/Responsibilities:Reviews and prepares cases for medical necessity review of Applied Behavior Analysis (ABA). Provide input into medical management programs/policies that pertain to neurodevelopmental disorders. Make recommendation for enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols. Serves as a clinical SME supporting SIU Investigators, Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases Completion of Fraud waste and abuse reviews in partnership with SIU. Providers SME support to enterprise-wide initiatives supporting members with neurodevelopmental disorders. Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. Researches and prepares cases for clinical and legal review. Provides day-to-day support and guidance for ABA prior authorization clinical team and the health plan medical directors. Attends and participates in clinical meetings with care management and utilization management. Provides subject matter expertise on all ABA-related questions and member issues. Supports provider education initiatives for providers with a neurodiverse specialty including quality assurance and Fraud waste and abuse issues. Required QualificationsGreater Phoenix, Arizona area resident National Board Certified Behavior Analyst-Doctoral (BCBA-D) and unencumbered license by the Arizona Board of Psychologist Examiners to practice as a Behavior AnalystFive years of post-graduate direct patient care experience. Five (5) or more years of experience in clinical practice in the assessment and treatment of neurodevelopmental disorders, including but not limited to, Autism. PhD or PsyD, with specialization in neurodevelopment and child and adolescent psychology Direct experience providing treatment in the Autism space (e. g. , ABA, NDBI, EIBI) Ability to travel up to10% for mandatory office meetings and local travel Preferred QualificationsExperience with and knowledge of CPT and HCPCS coding guidelines and principles Experience using clinical expertise in reviewing medical records and making claim payment determinations according to Company, State, Federal and industry standard coding principles and guidelines. Education Doctoral degree (Ph. D. or equivalent) in a field related to behavior analysis Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$100,425. 00 - $216,300. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/02/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Aetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. Under the direction of the Lead Director, Service Operations, this position will focus on utilization, quality and fraud waste and abuse review for individual cases for members across Aetna . This role is fully remote. Eligible candidates must be licensed in Arizona and live in the greater Phoenix area. Expectations/Responsibilities: + Reviews and prepares cases for medical necessity review of Applied Behavior Analysis (ABA). + Provide input into medical management programs/policies that pertain to neurodevelopmental disorders. + Make recommendation for enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols. + Serves as a clinical SME supporting SIU Investigators, Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases Completion of Fraud waste and abuse reviews in partnership with SIU. + Providers SME support to enterprise-wide initiatives supporting members with neurodevelopmental disorders. + Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. + Researches and prepares cases for clinical and legal review. + Provides day-to-day support and guidance for ABA prior authorization clinical team and the health plan medical directors. + Attends and participates in clinical meetings with care management and utilization management. Provides subject matter expertise on all ABA-related questions and member issues. + Supports provider education initiatives for providers with a neurodiverse specialty including quality assurance and Fraud waste and abuse issues. **Required Qualifications** + Greater Phoenix, Arizona area resident + National Board Certified Behavior Analyst-Doctoral (BCBA-D) and unencumbered license by the Arizona Board of Psychologist Examiners to practice as a Behavior Analyst + Five years of post-graduate direct patient care experience. + Five (5) or more years of experience in clinical practice in the assessment and treatment of neurodevelopmental disorders, including but not limited to, Autism. + PhD or PsyD, with specialization in neurodevelopment and child and adolescent psychology + Direct experience providing treatment in the Autism space (e.g., ABA, NDBI, EIBI) + Ability to travel up to10% for mandatory office meetings and local travel **Preferred Qualifications** + Experience with and knowledge of CPT and HCPCS coding guidelines and principles + Experience using clinical expertise in reviewing medical records and making claim payment determinations according to Company, State, Federal and industry standard coding principles and guidelines. **Education** Doctoral degree (Ph.D. or equivalent) in a field related to behavior analysis **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $100,425.00 - $216,300.00 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 01/02/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Location: This role will be work at home with 50-75% travel within north side of Chicago. (Lakeview, Lincoln Park and surrounding areas. ) Schedule: Standard business hours Monday-Friday 8:00am-5:00pm CST. Program OverviewHelp 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. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Family Summary/MissionFacilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. Position SummaryOur 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. Key ResponsibilitiesActs 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 determination of 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, optimize 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. Work Environment & TravelAbility to work independently from home office using virtual collaboration tools and electronic systems. Ability to travel within a designated geographic area in Illinois to conduct in-person case management activities at members' residences. Required QualificationsLicensure/Education (must meet one of the following):Active Licensed Clinical Social Worker (LCSW) in the state of Illinois with a Master's degree in social work, ORActive Licensed Clinical Professional Counselor (LCPC) in the state of Illinois with a Master's degree in counseling or related field. Work Experience:Minimum of 3-5 years of clinical experience, preferably in behavioral health. Minimum of 2-3 years of experience in case management, discharge planning, and/or home health care coordination. Preferred QualificationsCase management and discharge planning experience. Managed care/utilization review experience. Crisis intervention skills. Strong analytical and problem-solving skills. Effective written and verbal communication skills. Strong organizational and interpersonal skills. Ability to work independently while collaborating effectively with interdisciplinary teams. Proficiency with standard corporate software applications (Microsoft Word, Excel, Outlook, PowerPoint) and ability to quickly learn proprietary applications. High level of computer efficiency, including navigating multiple systems, multitasking across platforms, and accurate keyboarding. EducationMaster's degree Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$66,575. 00 - $142,576. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/31/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Title: Behavioral Health Specialist Requires LISW, LPCC or LMFTCompany: Oak Street HealthRole Description:The purpose of a Behavioral Health Specialist at Oak Street Health is to provide care management services and to provide evidence-based short-term psychotherapy to our patients with behavioral health needs. The Behavioral Health Specialist is a key resource for Care Teams across a region of Oak Street Health primary clinics. They are responsible for coordinating and supporting behavioral healthcare for our patients, in collaboration with Care Teams and a psychiatric consultant. The Behavioral Health Specialist will assess the needs of patients, make referrals to appropriate behavioral health resources and specialists, and provide short-term counseling and evidence-based treatments as indicated. This role has the potential option for remote work days based upon achievement and maintenance of program metrics. Core Responsibilities:Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health ProgramScreen and assess patients for common mental health and substance use disorders Develop care plans and provide or facilitate referrals to Oak Street's psychiatric consultant and/or external resources Provide short-term counseling and evidence-based treatments Coordinate care with Oak Street's psychiatric consultant, including warm handoffs for telehealth visits and collaboration on care plans Develop relationships with primary care teams and consistently communicate changes in behavioral health care plans Accurate and timely documentation of patient encounters and counseling sessions in Oak Street's electronic medical record Participate in regional and organizational efforts to advance Oak Street's Behavioral Health Program through workshops, feedback sessions, and surveys Possibly covering multiple clinics, depending on the maturity and panel sizes of those clinics Other duties, as assigned What are we looking for?Required:Master's Degree in the field of mental health counseling/healing arts required from an accredited school (Social Work, Counseling, Marriage and Family Therapy, etc. ) Highest clinical level of license (or local equivalent) Experience with screening for common mental health and/or substance use disorders Experience with assessment and treatment planning for common mental health and/or substance use disorders Familiarity with brief, structured intervention techniques (e. g. , Motivational Interviewing, Behavioral Activation, Problem Solving, Cognitive Behavioral, etc. ) US work authorization Strongly Preferred:Proficiency in providing brief, structured intervention techniques (e. g. , Motivational Interviewing, Behavioral Activation, Cognitive Behavioral) Working knowledge of differential diagnoses of common mental health and/or substance use disorders Preferred:Proficient PC skills Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/09/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Program Overview:** 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. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. **Family** **Summary/Mission** Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. **Position Summary** 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. **Key Responsibilities** + 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 determination of 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, optimize 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. **Work Environment &** **Travel** + Ability to work independently from home office using virtual collaboration tools and electronic systems. + Ability to travel within a designated geographic area in Illinois to conduct in-person case management activities at members' residences. **Required Qualifications** Licensure/Education (must meet one of the following): + Active Licensed Clinical Social Worker (LCSW) in the state of Illinois with a Master's degree in social work, OR + Active Licensed Clinical Professional Counselor (LCPC) in the state of Illinois with a Master's degree in counseling or related field. Work Experience: + Minimum of 3-5 years of clinical experience, preferably in behavioral health. + Minimum of 2-3 years of experience in case management, discharge planning, and/or home health care coordination. **Preferred Qualifications** + Strong analytical and problem-solving skills. + Effective written and verbal communication skills. + Strong organizational and interpersonal skills. + Ability to work independently while collaborating effectively with interdisciplinary teams. + Proficiency with standard corporate software applications (Microsoft Word, Excel, Outlook, PowerPoint) and ability to quickly learn proprietary applications. + High level of computer efficiency, including navigating multiple systems, multitasking across platforms, and accurate keyboarding. **Education** + Master's degree **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $66,575.00 - $142,576.00 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 01/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryFully remote in the USA; Shift Monday through Friday standard business hours, 8am to 5pm. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psycho social wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members:Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. Required Qualifications3 years of direct clinical practice experience post master's degree, e. g. , hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility3 years required knowledge of mental health and substance abuse disorders 3 years experience, must be able to talk on the telephone and type at the same time3 years experience using Motivational Interviewing and good technological skills Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required:(LCSW Licensed Clinical Social Worker, LISW Licensed Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) Must be willing and able to work Monday through Friday, 8:00am to 5:00pm in time zone of residence Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred Managed care/utilization review experience preferred EducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryFully remote in the USA. Shift Monday-Friday standard business hours. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members:Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. - Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. Required Qualifications3 years of direct clinical practice experience post master's degree, e. g. , hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility Requires 3 years of knowledge of mental health and substance abuse disorders 3 years experience talking on the telephone and typing at the same time3 years Experience using Motivational Interviewing and good technological skills Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required:(LCSW Licensed Clinical Social Worker, LISW Licensed, Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred EducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$60,522. 00 - $129,615. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/18/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Fully remote in the USA. Shift Monday-Friday standard business hours. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of Members: Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. - Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. **Required Qualifications** + 3 years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility + Requires 3 years of knowledge of mental health and substance abuse disorders + 3 years experience talking on the telephone and typing at the same time + 3 years Experience using Motivational Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required:(LCSW Licensed Clinical Social Worker, LISW Licensed, Independent Social Worker, LCPC Licensed Clinical Professional Counselor, LP Licensed Psychologist, LMFT Licensed Marriage and Family Therapist, LMHC Licensed Mental Health Counselor) **Preferred Qualifications** + Crisis intervention skills preferred + Managed care/utilization review experience preferred + Case management and discharge planning experience preferred **Education** Masters Degree in Social Work or Counseling required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $60,522.00 - $129,615.00 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/18/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryUtilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Telephonic clinical case management with Medicare population. Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs. Completes a Comprehensive Assessment and Plan of care. Will document in clinical systems to support legacy Aetna and Coventry membership. Provides BH consultation and collaboration with Aetna partners. Active participation in clinical treatment rounds. Active participation in team activities focused on program development. Innovative thinking expected. The majority of time is spent at a desk on telephonic member outreaches and computer documentation. Assist members with locating community based behavioral health resources. Required Qualifications3+ years of direct clinical practice experience An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC, LISW, LSW) Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service Bilingual Spanish and English Preferred QualificationsCrisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred Discharge planning experience Utilization review, prior authorization, concurrent review, appeals experience CCM preferred DSNP experience a plus Knowledge of Substance Abuse DisordersEducationMasters Degree in Social Work or Counseling required Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$54,095. 00 - $116,760. 00This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 11/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary: Accountable for the delivery of outstanding Absence Management and related Colleague Services through a strong commitment to colleague experience. The Case Manager, Enterprise Absence Management will be responsible for using the CVS Health my Leave absence platform as well as other HR systems to administer FMLA, State regulations and Company leave policies from the start of a leave request through the return to work. Job Description: + Support a service delivery model that reflects empathy and care for all colleagues and fosters an environment focused on the colleague experience + Administer leave of absence requests under FMLA, State regulations and Company leave policies in accordance with federal and state regulations + Utilize the my Leave system for leave of absence to ensure tasks and cases are completed according to federal and state regulations + Review and analyze leave of absence requests that are not eligible for FMLA, State and / or Company leave policies to determine if the ADA is applicable. If request for a leave of absence does require a review for the ADA, update and assign the case for Reasonable Accommodation review + Research and resolve tier 2 escalations and ensure the outcome and updates are documented and communicated timely + Review, calculate and submit payment of paid time off for leave requests in accordance with FMLA, State regulations and Company leave policies + Review, calculate and submit payment of the CVS Health Paid Parental Leave according to the policy + Conduct colleague outreach calls at the start of a new leave request and at key intervals throughout the leave process to ensure colleague support through the leave + Communicate with colleagues, leaders, and other key stakeholders to assist with questions on leave administration + Work collaboratively with members of the LOA Team to ensure compliance, completing goals and putting the customer first + All other leave of absence case management duties assigned by Case Management Lead and / or other key members of the my Leave team + A strong commitment to Customer Service as exemplified by behaviors and disposition + Ability to work independently and as part of a team environment + Excellent written, verbal and listening skills to reflect a friendly, positive disposition + Demonstrated ability to maintain work in the strictest of confidence + Demonstrated ability to problem solve and apply critical thinking skills, including the ability to think analytically and creatively, under pressure, to solve problems + Strong organizational and data entry skills with a strict attention to detail + Ability to plan and prioritize workloads, both independently and in a team environment with minimal supervision + Demonstrated ability to think strategically and creatively toward continuous improvement of operations both technically and functionally + Ability to consistently and efficiently follow through on problems to provide resolution that is satisfactory to the customer + Demonstrated ability to multi-task while consistently meeting deadlines + Proficiency with MS Office Products + Regular and predictable attendance is required + Minimum internet connection of 25 Mbps download speed and 3 Mbps upload speed required Required Qualifications: 1+ year of customer service or office experience Preferred Qualifications: FMLA, State Leaves, Disability, or HR experience Education: High School Diploma or GED **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/24/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Schedule:** Monday-Friday 8AM - 5PM Central **Travel:** Up to 55-75% travel in Chicago; Lake Forest area **Position Summary** Program Overview Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. 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. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. **Family Summary/Mission** Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies, and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. **Position Summary/Mission** Community Care Case Manager 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. **Fundamental Components & Physical Requirements** - 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 determination of 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. - Testifies as required to substantiate any relevant case work or reports. - 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, optimize 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** + Active Registered Nurse IL /Compact License + Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. + Minimum 2+ years CM, discharge planning and/or home health care coordination experience + Previous Utilization Management experience, transitions of care and discharge planning required + Registered Nurse with active state license in good standing within the region where job duties are performed is required. **Preferred Qualifications** + Ability to occasionally travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise + Excellent analytical and problem-solving skills + Effective communications, organizational, and interpersonal skills. + Ability to work independently (may require working from home). + Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. + Efficient and Effective computer skills including navigating multiple systems and keyboarding + Willing and able to obtain multi state RN licenses if needed, company will provide. + Certified Case Manager is preferred. + Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required **Education** + Associates degree with equivalent experience, applicant would be required to obtain a bachelor's degree within 3+ years as part of role development, state licensing laws may apply + Bachelor's degree preferred **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $66,575.00 - $142,576.00 This 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. Our 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. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/24/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary:Accountable for the delivery of outstanding Absence Management and related Colleague Services through a strong commitment to colleague experience. The Case Manager, Enterprise Absence Management will be responsible for using the CVS Health my Leave absence platform as well as other HR systems to administer FMLA, State regulations and Company leave policies from the start of a leave request through the return to work. Job Description:Support a service delivery model that reflects empathy and care for all colleagues and fosters an environment focused on the colleague experience Administer leave of absence requests under FMLA, State regulations and Company leave policies in accordance with federal and state regulations Utilize the my Leave system for leave of absence to ensure tasks and cases are completed according to federal and state regulations Review and analyze leave of absence requests that are not eligible for FMLA, State and / or Company leave policies to determine if the ADA is applicable. If request for a leave of absence does require a review for the ADA, update and assign the case for Reasonable Accommodation review Research and resolve tier 2 escalations and ensure the outcome and updates are documented and communicated timely Review, calculate and submit payment of paid time off for leave requests in accordance with FMLA, State regulations and Company leave policies Review, calculate and submit payment of the CVS Health Paid Parental Leave according to the policy Conduct colleague outreach calls at the start of a new leave request and at key intervals throughout the leave process to ensure colleague support through the leave Communicate with colleagues, leaders, and other key stakeholders to assist with questions on leave administration Work collaboratively with members of the LOA Team to ensure compliance, completing goals and putting the customer first All other leave of absence case management duties assigned by Case Management Lead and / or other key members of the my Leave teamA strong commitment to Customer Service as exemplified by behaviors and disposition Ability to work independently and as part of a team environment Excellent written, verbal and listening skills to reflect a friendly, positive disposition Demonstrated ability to maintain work in the strictest of confidence Demonstrated ability to problem solve and apply critical thinking skills, including the ability to think analytically and creatively, under pressure, to solve problems Strong organizational and data entry skills with a strict attention to detail Ability to plan and prioritize workloads, both independently and in a team environment with minimal supervision Demonstrated ability to think strategically and creatively toward continuous improvement of operations both technically and functionally Ability to consistently and efficiently follow through on problems to provide resolution that is satisfactory to the customer Demonstrated ability to multi-task while consistently meeting deadlines Proficiency with MS Office ProductsRegular and predictable attendance is required Minimum internet connection of 25 Mbps download speed and 3 Mbps upload speed required Required Qualifications:1+ year of customer service or office experience Preferred Qualifications:FMLA, State Leaves, Disability, or HR experience Education:High School Diploma or GEDAnticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This 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. Our 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/24/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.