Description
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 colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.
Job Details
- Location: This is a full-time telework position requiring 50-75% travel in and around Northwest IL, including Winnebago, Boone, Stephenson, Ogle, Jo Daviess.
- Schedule: Standard business hours, Monday-Friday, 8:00am-5:00pm CST.
Position Summary
The Case Management Coordinator utilises critical thinking and judgement to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.
Key Responsibilities
- Evaluate members' needs and eligibility, and recommend approaches to case resolution.
- Identify high-risk factors and service needs that may impact member outcomes and care planning.
- Coordinate and implement assigned care plan activities and monitor care plan progress.
- Consult with case managers, supervisors, Medical Directors and other health programs to overcome barriers to meeting goals and objectives.
- Identify and escalate quality of care issues through established channels.
- Utilise negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
- Utilise influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behaviour changes to achieve optimum level of health.
- Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
- Engage with colleagues in ongoing team meetings and offer peer mentoring/training.
- Help members actively and knowledgeably participate with their provider in healthcare decision-making.
- Monitor, evaluate and document care in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
- 2+ years of experience in Behavioural Health, Social Services or a related field.
- Must be willing and able to travel 50-75% of the time in Winnebago, Boone, Stephenson, Ogle and Jo Daviess Counties, Illinois.
- Reliable transportation required; mileage is reimbursed per company expense reimbursement policy.
- 2+ years of experience with electronic documentation and Microsoft Office applications.
Preferred Qualifications
- Case management and discharge planning experience.
- Managed Care experience.
Education
- Bachelor's degree or non-licensed master-level clinician required, with either degree being in Behavioural Health or Human Services (Psychology, Social Work, Marriage and Family Therapy, Counselling).
Anticipated Weekly Hours
- 40
Time Type
- Full-time
Pay Range
- $21.10 - $44.99
Benefits
- Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.