Behavioral Health Care Planner

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.

Schedule

Monday–Friday, 11:00 AM–7:30 PM EST (Some Company Holiday And Weekend Coverage May Be Required)

Pay

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.