Case Management Coordinator - Field – Must reside in South Cook County or Will County Illinois

CVS Health•Park Forest, IL

1d•Remote

About The Position

The Case Management Coordinator provides comprehensive healthcare management services to facilitate appropriate healthcare treatment, manage healthcare costs, and improve healthcare program and operational efficiency involving clinical issues. The work includes determining medical necessity and appropriateness, facilitating optimal outcomes, identifying and following through on quality and compliance opportunities, and potentially identifying aberrances and initiating corrective action. The coordinator educates and empowers customers to support compliance, satisfaction, and patient advocacy, optimizes total costs, implements and evaluates policies based on usage and program directives, and educates colleagues at all levels to support decision-making at the most appropriate level. This is a work-from-home position requiring 50–75% travel to meet members face to face. The candidate must reside in South Cook County or Will County, Illinois, or surrounding areas; the posting particularly identifies ZIP codes 60461, 60443, 60471, and 60466. Standard business hours are Monday through Friday. The position requires use of the employee’s own vehicle, with mileage reimbursement available according to company policy.

Requirements

At least 2 years of experience in behavioral health, social services, or a human services field.
At least 2 years of case management experience.
Reside in South Cook County or Will County, Illinois, or surrounding areas.
Be willing and able to travel using a personal vehicle up to 50–75% of the time to meet members face to face in South Cook County and surrounding areas.
Have reliable transportation.
Hold a valid Illinois Driver’s License.
Have a bachelor’s degree or be a non-licensed master-level clinician; either degree must be in behavioral health, social services, or a human services field.

Nice To Haves

Case management and discharge planning experience.
Managed care experience.
Microsoft Office experience, specifically Excel.

Responsibilities

Determine medical necessity and appropriateness.
Facilitate optimal healthcare outcomes.
Identify and follow through on continuous quality and compliance opportunities; identify aberrances and initiate corrective action when applicable.
Educate and empower customers to support compliance, satisfaction, and patient advocacy.
Optimize total costs.
Implement and evaluate policy based on usage and program directives.
Educate and empower colleagues at all levels to enable decision-making at the most appropriate level.
Travel to meet members face to face.