Intensive Case Management Analyst- Field- Must reside in Jefferson County

CVS Health•Louisville, KY

19h•$21 - $37•Onsite

About The Position

Aetna Better Health is hiring multiple Case Management Coordinators across Kentucky. The role uses critical thinking and professional judgment to support case management and improve healthcare outcomes for members through advocacy, coordination, support, and education, using care management tools and resources. This is a field position assigned to Jefferson County in the Jefferson Region. It requires regional in-state travel 80–90% of the time, including face-to-face visits with members at homes, schools, hospitals, doctors’ offices, and DCBS offices. Reliable transportation is required, and travel to the Louisville office for meetings and training is anticipated. Candidates must reside in Jefferson County. The schedule is 40 hours per week, with core business hours of Monday–Friday, 8 a.m.–5 p.m. EST; flexibility to work outside those hours is required to meet the needs of children and families. The position evaluates members’ care needs using assessments and data, identifies risk factors, and coordinates wellness care plans. It works with case managers, supervisors, Medical Directors, and other health programs to address barriers and improve outcomes. The role also supports member engagement and informed healthcare decision-making, escalates quality-of-care concerns, and documents care in compliance with applicable guidelines and company policies.

Requirements

At least 6 months of experience in foster care and juvenile justice systems, adoption assistance, behavioral health services, trauma-informed care, ACEs, crisis intervention services, or evidence-based practices applicable to Kentucky SKY populations.
At least 2 years of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
At least 1 year of experience using Microsoft Office Suite applications, including Word and Excel.
Willingness and ability to travel 80–90% of the time to meet members face-to-face in the assigned region.
Must reside in Jefferson County.
Reliable transportation is required.
Bachelor’s or master’s degree in behavioral health or a relevant human services field, such as social work, psychology, marriage and family therapy, or counseling; a non-licensed master-level clinician is also accepted.
Flexibility to work beyond core business hours when needed.

Nice To Haves

At least 3 years of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
At least 1 year of managed care organization (MCO) experience.

Responsibilities

Evaluate members’ care needs using care management assessments and information or data review, and recommend approaches based on benefit plans and available programs and services.
Identify high-risk factors and service needs that may affect outcomes, and implement early, proactive support interventions.
Coordinate and implement wellness care plan activities and monitor members’ care needs.
Consult with case managers, supervisors, Medical Directors, and other health programs to address barriers to goals and objectives.
Present cases at case conferences for multidisciplinary review.
Identify and escalate quality-of-care issues through established channels.
Negotiate to secure appropriate options and services to meet members’ benefit or healthcare needs.
Use influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes.
Provide coaching, information, and support so members can make ongoing independent medical and healthy-lifestyle choices.
Help members participate actively and knowledgeably in healthcare decision-making with their providers.
Use case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Travel within the assigned region for face-to-face member visits and to the Louisville office for meetings and training.