Healthcare Case Manager: Member Advocate & Coordination

CVS Health; Hammond (LA); On-site; USD 2,907,000 - 5,067,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a full-time Case Management professional to conduct routine care coordination and education using care management resources to achieve optimal member outcomes. You will implement projects and administer policies within Case Management, applying practical knowledge to ensure quality care.

The role requires a Louisiana‑based candidate (Region 7) with a health care/human services degree and case management experience.

Qualifications

• Degree in Health Care/Human Services related field.
• Strong customer service orientation and problem solving skills.
• Excellent communication/telephonic skills.
• Excellent motivational interviewing skills/ability to build rapport and trust telephonically.

Responsibilities

• Consults with case managers, supervisors, medical directors and/or other health programs using a holistic approach, to overcome barriers to meeting goals and objectives.
• Presents cases at case conferences to obtain a multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Demonstrates negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Delivers 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.
• Assists in encouraging members to actively participate with their provider in healthcare decision‑making.
• Conducts comprehensive evaluations of referred members' needs/eligibility using care management tools and recommends an approach to case resolution.

Skills

Customer service

Communication

Problem solving

Time management

Motivational interviewing

Travel readiness

Education

Health Care/Human Services degree

CCM certification (preferred)

Job description

CVS Health is seeking a full-time Case Management professional to conduct routine care coordination and education using care management resources to achieve optimal member outcomes. You will implement projects and administer policies within Case Management, applying practical knowledge to ensure quality care.

The role requires a Louisiana‑based candidate (Region 7) with a health care/human services degree and case management experience.