Intensive Case Management Coordinator - Field- Jefferson County, KY

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.

About the role

Aetna Better Health is hiring for multiple openings across Kentucky. As a Case Management Coordinator (CMC), you will utilize 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. This is a telework position requiring regional, in-state travel 80-90% of the time. Qualified candidates must have reliable transportation and reside in Jefferson County, KY. 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.

Responsibilities

• Evaluation of Members: Use care management assessments and data review to recommend approaches for resolving care needs, ensuring optimal health and well-being. Evaluate members' benefit plans and available internal/external programs/services. Identify high-risk factors and service needs impacting member outcomes and implement early, proactive support interventions. Coordinate and implement wellness care plan activities and monitor member care needs.
• Enhancement of Medical Appropriateness and Quality of Care: Consult with case managers, supervisors, medical directors, and other health programs to overcome barriers to meeting goals. Present cases at multidisciplinary case conferences to achieve optimal outcomes. Identify and escalate quality-of-care issues. Utilize negotiation skills to secure appropriate options and services. Use motivational interviewing to ensure member engagement and promote lifestyle/behavior changes. Provide coaching and support to empower members in making independent medical and healthy lifestyle choices. Help members actively participate in healthcare decision-making with their providers.
• Monitoring, Evaluation, and Documentation of Care: Utilize case management and quality management processes in compliance with regulatory, accreditation, and company policies.

Requirements

• Minimum of 6 months of experience in Foster Care and juvenile justice systems, Adoption Assistance, delivery of Behavioral Health Services, Trauma-informed Care, ACEs (Adverse Childhood Experience), Crisis Intervention services, or evidence-based practices applicable to the Kentucky SKY (Supporting Kentucky Youth) populations.
• Minimum of 1 year of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
• Minimum of 1 year of experience in Microsoft 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.
• Must reside in Jefferson County, KY.

Qualifications

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

Preferred Qualifications

• 2+ years of experience in Foster Care and juvenile justice systems, Adoption Assistance, delivery of Behavioral Health Services, Trauma-informed Care, ACEs (Adverse Childhood Experience), Crisis Intervention services, or evidence-based practices applicable to the Kentucky SKY (Supporting Kentucky Youth) populations.

Schedule

• Full-time, 40 hours per week.
• Flexibility to work beyond core business hours (Monday-Friday, 8am-5pm EST) as needed.

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 range.

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.

Additional details about available benefits are provided during the application process and on Benefits Moments.