Case Management Coordinator – Field
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Job Description
Case Management Coordinator supporting member care, benefits access, and health outcomes for CVS Health across Northwest Illinois. Conducting evaluations, coordinating care plans, and traveling 50-75%.
Responsibilities:
- Conduct comprehensive evaluations of members’ needs and eligibility using care management tools and data review
- Recommend approaches to case resolution and meeting member needs by evaluating benefit plans and available programs/services
- Identify high-risk factors and service needs, with appropriate referral to clinical case management or crisis intervention
- Coordinate and implement 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 influencing and motivational interviewing skills to engage members and promote lifestyle/behavior changes
- Provide coaching, information and support for independent medical and healthy lifestyle choices
- Engage in team meetings and provide peer mentoring/training
- Help members participate knowledgeably with providers in healthcare decision-making
- Use case management and quality management processes in compliance with regulatory, accreditation and company guidelines
Requirements:
- 2+ years experience in Behavioral Health, Social Services or an appropriate related field equivalent to program focus
- Must be willing and able to travel 50-75% of the time in Winnebago, Boone, Stephenson, Ogle and Jo Daviess Counties, Illinois
- Reliable transportation required
- 2+ years of electronic documentation experience
- Microsoft Office applications experience
- Bachelor's degree or non-licensed master level clinician required, in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family Therapy, Counseling)
- Case management and discharge planning experience preferred
- Managed Care experience preferred
Benefits:
- Mileage is reimbursed per our 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
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