Case Management Coordinator (Remote)

CVS Health; Oregon; Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking company dedicated to transforming patient care through innovative solutions. As a Case Management Coordinator, you'll play a vital role in enhancing the health and well-being of dual eligible members. Your expertise in behavioral health and social services will help navigate complex healthcare needs, ensuring that members receive the support and resources they require. This full-time telework position offers a dynamic environment where your contributions will directly impact lives. If you're passionate about making a difference and thrive in a collaborative setting, this opportunity is perfect for you!

Benefits

Medical Benefits

Dental Benefits

Vision Benefits

401(k) Retirement Plan

Employee Stock Purchase Plan

Paid Time Off

Short-term and Long-term Disability Benefits

Education Assistance

CVS Store Discount

Well-being Programs

Qualifications

• 2+ years in behavioral health or social services required.
• Experience with Microsoft Office applications is essential.

Responsibilities

• Facilitate healthcare outcomes by assisting with scheduling and benefits.
• Conduct comprehensive evaluations and coordinate care plans.

Skills

Behavioral Health Experience

Social Services Experience

Microsoft Office

Quickbase

Case Management

Discharge Planning

Negotiation Skills

Motivational Interviewing

Education

Bachelor's Degree in Behavioral Health or Human Services

Non-licensed Master Level Clinician

Tools

Microsoft Outlook

Microsoft Teams

Microsoft Excel

Microsoft Word

Job description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

This is a full-time telework position.

The hours for this role are Monday-Friday 8:00 am - 5:00 pm in the time zone of residence.

Program Overview:

Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country.

Position Summary/Mission:

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.

Fundamental Components:

1. Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
2. 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.
3. Coordinates and implements assigned care plan activities and monitors care plan progress.
4. Enhancement of Medical Appropriateness and Quality of Care: Using a 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.
5. Identifies and escalates quality of care issues through established channels.
6. Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
7. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
8. Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
9. Helps member actively and knowledgeably participate with their provider in healthcare decision-making.
10. 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
• 2+ years of experience with Microsoft Office applications (Outlook, Teams, Excel, Word)

Preferred Qualifications:

• Case management and discharge planning experience preferred
• Managed Care experience preferred
• 2+ years of Quickbase experience

Education and Certification Requirements:

• Bachelor's degree required or non-licensed master level clinician with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) or equivalent experience

Pay Range:

The typical pay range for this role is: $19.52 - $36.78. 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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

We anticipate the application window for this opening will close on: 04/05/2024.

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions.