Case Management Coordinator Field Illinois (Metro EastSouthern Illinois)

Were building a world of health around every individual shaping a more connected convenient and compassionate health experience. At CVS Health youll be surrounded by passionate colleagues who care deeply innovate with purpose hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person one family and one community at a time.

Location: This is a full-time telework position requiring 50-75% travel in and around Metro east/Southern Illinois

Schedule: Standard business hours Monday-Friday 8:00am-5:00pm CST.

Position Summary
The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.

• Evaluation of Members: Through the use of care management tools and information/data review conducts comprehensive evaluation of members needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members benefit plan and available internal and external programs/services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case managers supervisors Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the members benefits and/or healthcare needs.
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Engages with colleagues in ongoing team meetings and offers peer mentoring/training.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Monitoring Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications

• 2 years experience in Behavioral Health Social Services or appropriate related field equivalent to program focus.
• Must be willing and able to travel 50-75% of the time in the Metro East Illinois area (Madison St. Clair Monroe Clinton Jersey Calhoun Bond Macoupin and surrounding areas). Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy.
• Must have 2 years of experience of electronic documentation experience and Microsoft Office applications.

Preferred Qualifications

• Case management and discharge planning experience.
• Managed Care experience.

Education

• Bachelors degree or non-licensed master level clinician required with either degree being in Behavioral Health or Human Services (Psychology Social Work Marriage and Family therapy Counseling)

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience education geography and other relevant factors. This position is eligible for a CVS Health bonus commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers patients members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.