Case Management Coordinator – Transition of Care Team
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Case management coordinator helping CVS Health members access healthcare, benefits, and education. Evaluating needs, coordinating care plans, and supporting healthier outcomes remotely.
Responsibilities:
- Evaluate referred members' needs and eligibility using care management tools and data review
- Recommend case-resolution approaches and evaluate benefit plans and internal/external programs and services
- Identify high-risk factors and service needs affecting member outcomes and care planning
- Refer members to clinical case management or crisis intervention when appropriate
- Coordinate, implement, and monitor assigned care plan activities
- Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
- Present cases at multidisciplinary case conferences
- Identify and escalate quality-of-care issues through established channels
- Negotiate appropriate options and services for members' benefits and healthcare needs
- Use motivational interviewing to engage members and promote lifestyle or behavior changes
- Provide coaching, information, and support for independent medical and healthy lifestyle choices
- Help members participate knowledgeably in healthcare decisions with providers
- Monitor, evaluate, and document care in compliance with regulatory, accreditation, and company requirements
Requirements:
- 2+ years of experience in behavioral health or social services
- Ability to work 8:00 AM–5:00 PM in the assigned market time zone
- 2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook)
- Dedicated workspace free of interruptions
- Separate care arrangements for dependents during work hours
- Case management and discharge planning experience preferred
- Managed care experience preferred
- Bachelor's Degree or non-licensed master level clinician degree in behavioral health or human services preferred, or equivalent experience (REQUIRED)
- Direct/hardwired internet connection to a modem/router within 7 feet of the computer
- Minimum internet speed of 25 Mbps download and 3 Mbps upload
- WiFi and satellite internet are not permitted
- Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
- Ability to work within the state and city where the candidate currently lives
- Microsoft Office 365 applications or similar Google Workspace experience
- Ability to navigate multiple monitors and applications
- Ability to use email, calendar invites, Teams messaging, and virtual meetings
- Ability to log in to secure systems such as VPN and EHR portals
- Ability to maintain strong passwords and recognize suspicious emails or links
- Ability to troubleshoot common technical issues independently
Benefits:
- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- Company-provided equipment, including keyboard, monitor, computer, and headset
Similar Jobs
Case Management Coordinator – Transition of Care Team
Remote Case Management Coordinator supporting CVS Health members with care plans, appointments, benefits, and healthcare access. Evaluating needs and coordinating quality-focused interventions.
Case Management Coordinator
Case Management Coordinator advancing Colorado Medicaid home care authorizations at Abby Care. Coordinating agencies, reauthorizations, appeals, and care continuity across Colorado’s LTHH ecosystem.
Case Management Coordinator, Maternity Focus
Case Management Coordinator focusing on maternity care management at BlueCross BlueShield of South Carolina. Responsible for care coordination and serving as an advocate for clients with chronic conditions.
No more related jobs available.