Case Management Coordinator – Field

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🔥 14 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

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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

• Conduct comprehensive evaluations of members’ needs and eligibility using care management tools and data review • Recommend case-resolution approaches by evaluating benefit plans and internal and external programs/services • Identify high-risk factors and service needs and refer members to clinical case management or crisis intervention when appropriate • Coordinate assigned care-plan activities and monitor progress • Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers • Present cases at case conferences for multidisciplinary review • Identify and escalate quality-of-care issues through established channels • Negotiate appropriate options and services to meet members’ benefits and healthcare needs • Use motivational interviewing and influencing skills to engage members and promote healthy lifestyle changes • Coach, inform, and support members in making independent medical and healthy lifestyle choices • Engage in team meetings and provide peer mentoring/training • Help members participate knowledgeably in healthcare decision-making with providers • Apply case-management and quality-management processes in compliance with regulatory, accreditation, and company requirements

🎯 Requirements

• 2+ years of experience in Behavioral Health, Social Services, or an appropriate related field equivalent to the program focus • Willingness and ability to travel 50-75% of the time in Cook County, Illinois • Reliable transportation required • Mileage reimbursement follows the company expense reimbursement policy • 2+ years of electronic documentation experience • Experience with Microsoft Office applications • Bachelor’s degree or non-licensed master level clinician required • Degree must be in Behavioral Health or Human Services, including Psychology, Social Work, Marriage and Family Therapy, or Counseling • Case management and discharge planning experience preferred • Managed Care experience preferred

🏖️ Benefits

• Mileage reimbursement according to the company expense reimbursement policy • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility • CVS Health bonus, commission or short-term incentive program eligibility