Case Management Coordinator, Assessor Team

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🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $21 - $44 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Evaluate members through care management tools and information/data review • Conduct comprehensive evaluation of referred member’s needs/eligibility • Recommend an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services • Identify high-risk factors and service needs that may impact member outcomes and care planning components • Coordinate and implement assigned care plan activities and monitor care plan progress • Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives • Present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes • Identify and escalate quality of care issues through established channels • Utilize negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs • Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices • Help member actively and knowledgably participate with their provider in healthcare decision-making • Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

🎯 Requirements

• Must reside in the state of Illinois • Must possess reliable transportation and be willing and able to travel up to 40% of the time from candidate home location • Must have computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word • Effective communication, telephonic and organization skills • Excellent analytical and problem-solving skills • Ability to work independently • Ability to effectively participate in a multi-disciplinary team including internal and external participants • 2 years’ experience in behavioral health, social services or appropriate related field equivalent to program focus

🏖️ Benefits

• medical coverage • dental coverage • vision coverage • paid time off • retirement savings options • wellness programs