Intensive Case Management Coordinator- Field - Jefferson County, Kentucky

Aetna Better Health is hiring for multiple openings across Kentucky. This is a telework position that requires regional in-state travel 80-90% of the time within Jefferson County. Qualified candidates must reside in Jefferson County and have reliable transportation. Travel to the Louisville office for meetings and training is anticipated. Flexibility to work beyond core business hours (Monday-Friday, 8am-5pm EST) is required to meet the needs of children and families.

About the role

The Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, facilitating and maintaining improved healthcare outcomes for members through advocacy, collaboration, coordination, support, and education using care management tools and resources.

Responsibilities

• Evaluate members through care management assessments and data review to recommend approaches for resolving care needs, maintaining optimal health and well-being by assessing member benefit plans and available programs/services.
• Identify high-risk factors and service needs that may impact member outcomes and implement early, proactive support interventions.
• Coordinate and implement Wellness care plan activities and monitor member care needs.
• Enhance medical appropriateness and quality of care by consulting with case managers, supervisors, Medical Directors, and other health programs to overcome barriers and achieve optimal outcomes.
• Present cases at case conferences to obtain multidisciplinary review.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services to meet member benefits and healthcare needs.
• Apply influencing and motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes.
• Provide coaching, information, and support to empower members to make independent medical and healthy lifestyle choices.
• Help members actively and knowledgeably participate with their providers in healthcare decision-making.
• Utilize case management and quality management processes in compliance with regulatory, accreditation, and company policies.

Requirements

• Minimum 6 months of experience in Foster Care and juvenile justice systems, Adoption Assistance, delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, or evidence-based practices applicable to the Kentucky SKY populations.
• Minimum 1 year of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
• Minimum 1 year of experience in MS Office Suite applications, including Word and Excel.
• Willing and able to travel 80-90% of the time to meet members face-to-face in the assigned region or other regions as needed.

Qualifications

• Minimum of a Bachelor's degree or a non-licensed master-level clinician in a behavioral health or human services field.

Schedule

• Full-time, 40 hours per week.

Pay

The typical pay range for this role is $21.10 - $36.78 per hour. This range represents the base hourly rate for positions in this job grade. The actual base salary offer will depend on factors including experience, education, geography, and other relevant considerations. This position is also eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay.

Benefits

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, including:

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources.