Description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Care Planner - Behavioral Health (Work at Home, U.S.)

Schedule: Monday-Friday, 11:00 AM-7:30 PM EST
(Some company holiday and weekend coverage may be required)
Location: Work from your home, anywhere in the United States

About the Role

Join the Behavioral Health Division of Aetna/CVS Health as a Care Planner, where you'll play a meaningful part in helping members access the behavioral health support and documentation they need. In this role, you'll collaborate with Medical Directors, clinicians, and customer service teams to support higher‑level case reviews and ensure timely, accurate processing.

You'll also help maintain our state regulatory compliance and support our NCQA accreditation-key functions that keep our care programs running smoothly and effectively.

What You'll Do

• Support clinical teams to enhance the quality and coordination of member care
• Prepare administrative and medical‑necessity determination letters with accuracy and clarity
• Communicate results of medical reviews to providers and utilization teams, including next steps
• Schedule and coordinate appointments between providers and Aetna Medical Directors or Consultants
• Gather appropriate documentation for clinical appointments and track deadlines to ensure timely completion
• Ensure compliance with state requirements and Aetna policies, using strong attention to detail across varying protocols

Required Qualifications:

• 2+ years of experience in at least one of the following:
  • Health insurance
  • Administrative/secretarial work
  • Customer service within a healthcare or mental health environment
• Ability to type 60-70 words per minute
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel)

Preferred Qualifications

• Strong organizational and time‑management abilities
• Excellent written and verbal communication skills
• Understanding of commercial insurance products
• Understanding of mental health and substance abuse related levels of care
• Strong attention to detail and ability to problem solve to meet specific requirements

Education

• Associate degree or equivalent experience, i.e healthcare industry experience.

Anticipated Weekly Hours
40

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.

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: 07/22/2026

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