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.
Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. As a Case Manager, you will have a life-changing impact on members enrolled in Medicare and Medicaid who present with complex health and social challenges.
Responsibilities:
- Conduct comprehensive assessments of referred members' needs and eligibility
- Apply clinical judgment to incorporate strategies designed to reduce risk factors and address complex clinical indicators
- Perform crisis intervention with members experiencing a behavioral health or medical crisis
- Collaborate with supervisors, Medical Directors, and other programs to overcome barriers to meeting goals and objectives
- Identify and escalate quality of care issues through established channels
- Utilize 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 ongoing independent medical and healthy lifestyle choices
- Analyze all utilization, self-report, and clinical data available to consolidate information and identify comprehensive member needs
- Develop and monitor established plans of care to meet members' goals
- Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Requirements:
- 3-5 years of clinical practical experience
- 2-3 years of case management, discharge planning, and/or home health care coordination experience
- Confidence working at home and independent thinking
- Reliable transportation and willingness to travel up to 50-75% in designated areas
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills
- Ability to work independently
- Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint
- Efficient and effective computer skills, including navigating multiple systems and keyboarding
Preferred Qualifications:
- Certified Case Manager is preferred
- Bilingual
Education:
- Master's Degree in Behavioral/Mental Health or a related field
License:
- LCSW or LCPC in the state of Illinois
Anticipated Weekly Hours:
- 40
Time Type:
- Full-time
Pay Range:
- $66,575.00 - $142,576.00