Remote Case Management Coordinator – Healthcare & Benefits

CVS Pharmacy; Aurora (IL); Remote; USD 60,460,000 - 128,914,000; Full time

Benefits offered by this job

Benefits package

Job summary

CVS Health is seeking a Case Management Coordinator (Field) to support care coordination across DuPage, Kane, DeKalb and Kendall counties. This full-time telework role involves 50-75% travel and standard business hours.

You will facilitate care plans, assist with scheduling, and help members access benefits through comprehensive case management tools. The ideal candidate has 2+ years in Behavioral Health or related fields, with experience in electronic documentation and MS Office.

Qualifications

• 2+ years experience in Behavioral Health, Social Services or appropriate related field equivalent to program focus.
• Willing to travel 50-75% of the time in DuPage, Kane, DeKalb, Kendall Counties, Illinois. Reliable transportation required.
• Must have 2+ years of experience of electronic documentation experience and Microsoft Office applications.

Responsibilities

• Evaluation of Members: conducts comprehensive evaluation of member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs.
• 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: 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.
• 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.
• 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.

Skills

Behavioral Health

Travel 50-75%

Electronic Documentation

Microsoft Office

Education

Bachelor's degree or non-licensed master level clinician in Behavioral Health or Human Services

Job description

CVS Health is seeking a Case Management Coordinator (Field) to support care coordination across DuPage, Kane, DeKalb and Kendall counties. This full-time telework role involves 50-75% travel and standard business hours.

You will facilitate care plans, assist with scheduling, and help members access benefits through comprehensive case management tools. The ideal candidate has 2+ years in Behavioral Health or related fields, with experience in electronic documentation and MS Office.