This is a work‑from‑home role within the United States, operating on standard business hours, Monday–Friday, 8:00 AM–4:30 PM (your time zone)

No nights. No weekends.

The position utilizes advanced clinical judgment and critical thinking to support members’ physical and behavioral healthcare needs. This is accomplished through comprehensive assessment and care planning, direct provider collaboration, and coordination of psychosocial wraparound services. The goal is to ensure effective use of available resources while achieving optimal, cost‑effective outcomes for each member.

Fundamental Components

• Provide telephonic clinical case management for the Medicare population.
• Apply Motivational Interviewing and other engagement strategies to enhance member participation in case management programs.
• Complete a Comprehensive Assessment and individualized Plan of Care
• Document all interactions in clinical systems supporting legacy Aetna and Coventry membership.
• Offer behavioral health consultation and collaborate with internal Aetna partners.
• Participate actively in clinical treatment rounds.
• Engage in team initiatives focused on program development— innovative thinking encouraged
• Spend the majority of work time conducting telephonic outreach and performing computer-based documentation.
• Assist members in locating appropriate community-based behavioral health resources

Required Qualifications

• 3+ years of direct clinical practice experience.
• Active and unrestricted clinical behavioral health license in the state of residence (e.g., LPC, LCSW, LMFT, LISW).
• Experience working within behavioral health on a multidisciplinary team supporting the Medicare population.
• Strong time‑management and organizational skills, with the ability to multitask in a fast‑paced environment.
• Ability to sit for extended periods while completing computer-based documentation.
• Motivational Interviewing experience is a plus.
• Access to a residential broadband internet connection of at least 25 Mbps download / 3 Mbps upload

Preferred Qualifications

• Crisis intervention skills.
• Experience in managed care and/or utilization review.
• Case management or discharge planning experience.

Education

• Minimum of a Master’s degree in Behavioral or Mental Health or a related field (e.g., Social Work, Counseling, Psychology).