Population Health and Wellness Care Management Coordinator

CVS Health Corporation; Kentucky; Remote; Full time

Job summary

CVS Health is seeking a Population Health and Wellness Care Management Coordinator. This remote position involves case management, healthcare coordination, and member advocacy to ensure optimal health outcomes. Ideal candidates will have a background in behavioral health, experience with healthcare services, and strong critical thinking skills.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Wellness screenings and counseling services

Flexible work schedules and paid time off

Qualifications

• 2 years’ experience in behavioral health or social services.
• Knowledge of trauma-informed care and crisis intervention services.
• Flexibility for after-hours work required.

Responsibilities

• Utilizes critical thinking to support the case management process and improve healthcare outcomes.
• Coordinates wellness care plan activities and monitors member care needs.
• Negotiates healthcare options and engages members to promote health.

Skills

Critical thinking

Collaboration

Advocacy

Education

Bachelor's degree in behavioral health or relevant field

Tools

MS Office Suite

Job description

Population Health and Wellness Care Management Coordinator page is loaded

Population Health and Wellness Care Management Coordinator

Apply remote type Remote locations KY - Work from home time type Full time posted on Posted Yesterday time left to apply End Date: June 30, 2025 (25 days left to apply) job requisition id R0528925

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The Population Health/Wellness Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, in order to facilitate and maintain improved healthcare outcomes for members by providing advocacy, collaboration coordination, support and education for members through the use of care management tools and resources.

This is a telework position that requires regional in-state travel 5-10% of the time.

Travel is with a personal vehicle. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation.

Travel to the Louisville office for meetings and training is also anticipated. This position is assigned to the Salt River Trail ( Breckinridge, Grayson, Meade, Hardin, Larue, Bullitt, Nelson, Marion, Washington, Spencer, Anderson, Woodford, Shelby, Franklin, Henry, Oldham, Trimble) .

The Population Health/Wellness Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, in order to facilitate and maintain improved healthcare outcomes for members by providing advocacy, collaboration coordination, support and education for members through the use of care management tools and resources.

Evaluation of Members: Through the use of care management assessments and information/data review, recommends an approach to resolving care needs maintaining optimal health and well-being by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and implements early and proactive support interventions Coordinates and implements Wellness care plan activities and monitors member care needs.

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 member’s 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.

Helps member actively and knowledgeably 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

Experience and detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations, is required.

-2 years’ experience in behavioral health, social services or appropriate related field equivalent to program focus.

-Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.

-Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, is required, as we are serving the needs of children and families that may require working after school, after work, etc.

Preferred Qualifications

-Knowledge of growth and developmental milestones.
-Case management experience
-Discharge planning experience
-Managed Care experience

Education

Minimum of a Bachelor's degree or a non-licensed master level clinician is required with either degree being in behavioral health or a relevant human services field of study (social work, psychology, marriage and family therapy, counseling)

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$21.10 - $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.

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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/30/2025

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

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About us

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.