Case Management Coordinator – Field
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Job Description
Case Management Coordinator supporting member evaluations, care plans, and healthcare access for CVS Health. Telework role with 50-75% travel across Lake, McHenry, and Northern Cook Counties.
Responsibilities:
- Conduct comprehensive evaluations of members’ needs and eligibility using care management tools and information/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 and refer members to clinical case management or crisis intervention as appropriate
- 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 for members’ benefits and healthcare needs
- Use influencing and motivational interviewing skills to engage members and promote lifestyle/behavior changes
- Provide coaching, information, and support to empower 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
- Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements
Requirements:
- 2+ years experience in Behavioral Health, Social Services or appropriate related field equivalent to program focus
- Willingness and ability to travel 50-75% of the time in Lake, McHenry, and Northern Cook Counties Illinois
- Reliable transportation required
- 2+ years of electronic documentation experience
- Experience with Microsoft Office applications
- 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, based on eligibility
- CVS Health bonus, commission or short-term incentive program eligibility
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