Case Management Coordinator (Remote, Illinois)

CVS Health•Peoria, IL

1d•$21 - $45•Remote

About The Position

This role requires up to 50% travel near candidate's residence in Illinois. The Case Management Coordinator utilizes critical thinking and judgment 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.

Requirements

2 years experience in behavioral health, social services or appropriate related field equivalent to program focus
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently in an autonomous environment; self starter
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
Efficient and Effective computer skills including navigating multiple systems and keyboarding
Must possess reliable transportation and be willing and able to travel up to 50% of the time from your home in the state of Illinois.
Candidates must have a dedicated workspace free of interruptions
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Nice To Haves

Case management and discharge planning experience
Managed Care experience preferred

Responsibilities

Conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
Coordinates and implements assigned care plan activities and monitors care plan progress.
Consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives.
Presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
Identifies and escalates quality of care issues through established channels.
Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve 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 knowledgably participate with their provider in healthcare decision-making.
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.