Case Management Coordinator

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Oversee, document, and communicate all elements of the utilization and benefit management program.

• Assess the needs and eligibility of referred members utilizing care management tools and data analysis.

• Propose case-resolution strategies by analyzing benefit plans along with available programs and services.

• Identify high-risk factors and service requirements and make suitable referrals.

• Coordinate and execute assigned care plan activities while monitoring progress.

• Employ a holistic approach to address barriers and achieve goals and objectives.

• Present cases during multidisciplinary case conferences for comprehensive review.

• Recognize and escalate quality-of-care concerns through appropriate channels.

• Negotiate suitable options and services to satisfy members’ benefit and healthcare requirements.

• Utilize influencing and motivational interviewing techniques to engage members and encourage lifestyle and behavioral changes.

• Offer coaching, information, and support for independent medical decisions and healthy lifestyle choices.

• Assist members in making informed healthcare decisions with their providers.

• Implement case management procedures in adherence to regulatory, accreditation, and company standards.

• Travel within Maricopa County to meet with members.

⛳️ Requirements

• Minimum of 2 years of experience in case management.

• Experience with individuals classified as having a serious mental illness (SMI).

• Experience working with senior citizens.

• Must reside in Maricopa County, Arizona.

• Willingness to travel up to 50% of the time within Maricopa County, Arizona.

• Bachelor’s degree in Social Work, Psychology, Special Education, Counseling, or possess a valid Arizona RN license.

• Preferred: residence in the West Valley, Maricopa County, AZ.

• Preferred: experience assisting members with physical disabilities.

• Strong organizational and time management capabilities.

• Ability to collaborate effectively with internal and external partners.

• Proficiency in Microsoft Office Suite, including Outlook and Word.

• Preferred: experience collaborating with healthcare professionals.

• Preferred: bilingual in English and Spanish.

🏝️ Benefits

• $5,000 sign-on bonus.

• CVS Health bonus, commission, or short-term incentive program.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being, based on eligibility.

• Work-from-home arrangement.