Clinical Case Manager Behavioral Health - Field

n, one family and one community at a time.

Position Summary

This is telework position with up to 50-75% travel in designated region of Illinois. Standard working hours can be anywhere within 8am - 9pm as needed to meet business needs. This Care Manager BH role requires working until 9pm for two (2) days a week. Care Manager BH coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members. Develops strategy to address issues to outcomes and opportunities to enhance member's overall wellness through integration. Instructs programs and procedures in compliance with network management and clinical coverage policies.

Essential Duties and Responsibilities:
• Executes evaluation of member needs and benefit plan eligibility and facilitates member transition to the organization's programs and plans
• Applies advanced clinical judgement to incorporate strategies designed to reduce risk factors and barriers, and to address complex health indicators that impact care planning and resolution of member issues.
• Handles reviews of prior claims to address potential impact on current case management and eligibility.
• Creates a holistic approach to assess the need for referrals to clinical resources and to assist in determining functionality.
• Ensures case management processes follow organization and regulatory requirements.
• Implements systems to maximize member engagement, discern health status and needs, and to assess member levels of work capacity and restrictions.
• Coaches and trains junior colleagues in techniques, processes, and responsibilities.
• Primarily works with members enrolled into Pathways to Success Program for intensive care coordination support.

Required Qualifications
• Clinical licensure
• Minimum two years experience working with children living with special needs or children in foster care
• Willing and able to travel up to 50-75% of their time to meet members face to face within one hour of their location
• Reliable transportation required; mileage is reimbursed per company expense reimbursement policy
• Willing and able to work until 9:00pm two (2) days a week

Preferred Qualifications

Managed Care experience

Case Management experience

Education Masters Degree in Social Work or any related field

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 04/14/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.