Case Management Coordinator - Field Illinois (Cook County)

About the role

The Case Management Coordinator at CVS Health is responsible for collaborating and informing the case management process. They provide assistance with appointment scheduling, identify and assist with accessing benefits and education for members through the use of care management tools and resources.

Responsibilities

• Evaluation of Members: Conducts comprehensive evaluation of 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.
• Identifies High Risk Factors: 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 Care Plan Activities: Coordinates and implements assigned care plan activities and monitors care plan progress.
• Enhances Medical Appropriateness and Quality of Care: Uses a holistic approach to consult 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.
• Escalates Quality of Care Issues: 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.
• Influencing/Motivational Interviewing: Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Coaching, Information and Support: Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Team Meetings and Peer Mentoring: Engages with colleagues in ongoing team meetings and offers peer mentoring/training.
• Healthcare Decision-Making: Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Monitoring, Evaluation and Documentation: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

• 2+ years experience in Behavioral Health, Social Services or appropriate related field equivalent to program focus.
• Must be willing and able to travel 50-75% of the time in Cook County, Illinois. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy.
• Must have 2+ years of experience of electronic documentation experience and Microsoft Office applications.

Qualifications

• Bachelor's degree or non-licensed master level clinician required with either degree being in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family therapy, Counseling).

Preferred Qualifications

• Case management and discharge planning experience.
• Managed Care experience.

Pay and Benefits

The Typical Pay Range For This Role Is $21.10 - $44.99. 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.