Remote Case Management Coordinator — Healthcare Navigator

CVS Health Corporation; Elgin (IL); Remote; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health Corporation is seeking a Case Management Coordinator to collaborate with care teams and inform the case management process. You will help members access benefits, education, and scheduling, using care management tools to support optimal healthcare outcomes.

You will evaluate member needs, coordinate care plan activities, and escalate quality issues as part of a holistic care approach, while engaging with colleagues through regular team meetings and mentoring peers.

Qualifications

• 2+ years experience in Behavioral Health, Social Services or related field.
• Willing to travel 50–75% in Cook County, IL with reliable transportation.
• 2+ years of electronic documentation experience and Microsoft Office applications.

Responsibilities

• Evaluate members' needs/eligibility and recommend case resolution strategies.
• Identify high risk factors and coordinate appropriate referrals.
• Coordinate and monitor care plan activities and progress.
• Consult with care team to improve quality of care and outcomes.
• Identify and escalate quality of care issues via established channels.
• Use negotiation to secure services meeting member benefits and needs.
• Apply motivational interviewing to promote engagement and healthy behaviors.
• Provide coaching and information to empower member decisions.
• Participate in team meetings and mentor peers.
• Support member engagement with providers in decision-making.
• Document and monitor care following regulatory and company policies.

Skills

Travel willingness

Electronic documentation

Microsoft Office

Education

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

Job description

CVS Health Corporation is seeking a Case Management Coordinator to collaborate with care teams and inform the case management process. You will help members access benefits, education, and scheduling, using care management tools to support optimal healthcare outcomes.

You will evaluate member needs, coordinate care plan activities, and escalate quality issues as part of a holistic care approach, while engaging with colleagues through regular team meetings and mentoring peers.