Clinical Case Manager Behavioral Health Auditor - #604226

CVS Health

Date: 11/25/2021 22:00 PM

City: Kenner, Louisiana

Contract type: Full Time

Work schedule: Full Day

The BH Clinical Auditor is a clinical leader in the Medicaid plan focusing on objectively assessing the completion and quality of required documentation for services delivered to clients receiving mental health services at all Agency sites. This position is responsible for behavioral health record auditing, identification of training needs, implementing corrective action plans, training facilitation, and assistance with implementation of processes and procedure in provider practices. Auditors represent the plan and collaborate with State government, key stakeholders, community organizations, and leadership team to enhance the quality of services provided to Aetna members and to ensure adherence to performance targets of the business area, and compliance to ABHLA, State, Federal and Accreditation standards

Required Qualifications

  • 3+ years behavioral health clinical experience required, in behavioral health, mental health or psychiatric care
  • 3+ years’ experience working as a Medicaid behavioral health clinical provider

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

  • Medicaid behavioral health services strongly preferred
  • Experience working in an office setting and engaging in
administrative duties

  • Experience providing in-service training and promote
provider staff development to ensure adherence to

quality assurance and policies and procedures

  • Strong relationship builder, self-motivated, and confident
making decisions, ability to influence and shape

outcomes, a strong clinical consultant.

  • Experience with LDH and Medicaid clinical standards
and guidelines

  • Strong analytical, verbal and written communication
skills; demonstrated ability to communicate effectively

with all levels of management, including senior


  • Advanced analytical and innovative problem-solving

  • Proficiency in use of statistical software (SPSS)
  • Proficiency with MS Office Suite, Word, Excel, Outlook,
etc. and strong keyboard navigation skills

- Experience with delivery/supervision of community



  • Master’s Degree in a Behavioral Health field and/or Human

  • Licensed as an LPC, LCSW, LMSW, or PLPC

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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