Bringing our heart to every moment of your health.
Care Planner Team Lead
Location
United States
Posted
2 days ago
Salary
$21 - $45 / hour
Seniority
Lead
No structured requirement data.
Job Description
Care Planner Team Lead
CVS Health
Role Description Provides guidance and support to a team of health services professionals by helping them understand their roles, responsibilities, and performance expectations. Supports clinical health services supervisors with resources and responsibilities. - Demonstrate strong leadership presence by modeling professionalism, accountability, and organizational values. - Serve as the primary point of contact for workflow and process‑related questions, providing guidance and clarification to team members. - Maintain a high‑level understanding of team roles, responsibilities, and workflows to support operational consistency and adherence to standards. - Assist leadership with audits and quality assurance activities. - Support work distribution and caseload management, helping to balance workload across the team and identify capacity concerns. - Act as a resource for best practices, process improvements, and issue escalation when appropriate. - Collaborate with leadership to promote efficiency, accuracy, and quality outcomes across the team. - Supports the professional growth of team members by promoting a culture of continuous learning and providing team members with ongoing education and development opportunities. - Promote a positive and supportive work environment that encourages collaboration and respect. - Support teamwork by encouraging knowledge sharing, and actively support and participate in employee engagement initiatives, including team activities and recognition efforts. The Analyst, Care Planner Behavioral Health role provides comprehensive behavioral health care management support to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issues. Additional responsibilities included but not limited to the following: - Provides comprehensive support and service to behavioral health clinical teams in support of member engagement and to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issues. - Provides outreach to members to educate them about available specialty programs and to solicit their participation. - Assists members locate services. Facilitates follow-up calls. - Collects information on patient progress and adherence to treatment plan. - Provides information to members regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Aetna policies and procedures. - Works closely with the clinician to ensure healthy outcomes for the member. - Miscellaneous administrative duties such as provider/community resource searches and documenting discharge verifications. - Work requires sitting for extended periods, talking on the telephone and typing into the computer. - Monitor referral task lists in multiple systems. - Log and assign new case management cases to Case managers across department. - Verify eligibility for case management by verifying member's insurance coverage. - Ensure applicable turnaround times are met. - Participates in designated team meetings with team members and clinical staff. - Adheres to compliance and Patient Management policies and regulatory requirements. - Maintains accurate and complete documentation of required information meeting risk management, regulatory, and accreditation requirements. - Participates in designated clinical quality management initiatives. - Required 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. Qualifications - Skilled in navigating rapid context switching between CM and UM responsibilities, leveraging deep behavioral health and managed care expertise to prioritize effectively. - Team player. - Adept at problem solving and decision-making skills. Requirements - Schedule: Monday - Friday 8:30 AM - 5:00 PM EST (No nights, no weekends and no Holidays). Preferred Qualifications - Demonstrated leadership skills or experience, including informal leadership, mentoring, or serving as a subject matter resource. Education - Associates Degree OR equivalent combination of education and experience. Time Type - Full time. Pay Range The typical pay range for this role is: $21.10 - $44.99. 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. Benefits - 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.
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