Case Management Coordinator

CVS Health • Oklahoma City, OK

1d • $21 - $37

About The Position

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. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Care Management Coordinators (CMC) drive and support care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The CMC utilizes critical thinking and judgment to collaborate and inform the care management/care coordination process in order to facilitate appropriate healthcare outcomes for assigned members. They provide care coordination, support and education for members through the use of care management tools and resources.

Requirements

• Case management and discharge planning experience preferred
• 2 years of related professional experience includes acting as a care manager, rehabilitation specialist, health specialist, social services coordinator, or licensed behavioral health professional in the State of Oklahoma
• Ability to travel up to 50% to meet members face to face based on member needs.
• Variable work schedules with ability to work 2 days weekly until 9pm local time
• Bachelor’s degree and/or Masters Degree in health care/human services related field, social work, psychology, or a related social services field

Nice To Haves

• Case management and discharge planning experience preferred
• Managed Care experience preferred
• Bilingual Spanish is preferred

Responsibilities

• Uses care management tools and information to complete a comprehensive evaluation of members and recommends an approach to case resolution by determining member needs in alignment with their benefit plan and available internal and external programs and services.
• Identifies high risk factors and service needs that may impact member outcomes and care planning with appropriate referral to clinical case management or crisis intervention as appropriate.
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve an optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledably participate with their provider in healthcare decision-making.
• Serves as a single point of contact for members and assists members to remediate immediate and acute gaps in care and access.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Using a holistic approach consults with clinical care managers, leadership, medical directors and other physical/behavioral health support staff and providers to overcome barriers to meeting member goals and objectives.
• Presents cases at case conferences/rounds to obtain multidisciplinary review in order to achieve optimal outcomes.
• Works collaboratively with the members’ interdisciplinary care team.
• In collaboration with the member and their care team develops and monitors established plans of care to meet the member’s goals.
• Identifies and escalates quality of care issues through established channels.
• Excellent Communication/Telephonic Skills Excellent Motivational Interviewing Skills/ability to build rapport and trust telephonically
• Monitors, evaluates and documents care utilizing case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
• Identifies, refers, and links members to providers and social supports as needed (e.g., scheduling appointments, arranging transportation).
• Educates members about available resources and services such as Oklahoma value-added benefits and assisting the member in accessing those resources and services.
• Facilitates clinical hand offs during transitions of care.
• Ability to support members with physical and behavioral health needs

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level