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.

• Utilize critical thinking, clinically relevant treatment knowledge, evidence-based practices, and medical necessity standards.

• Offer care coordination, assistance, and education through care management tools and resources.

• Perform thorough assessments of referred members’ needs and eligibility criteria.

• Suggest case-resolution strategies by analyzing benefit plans and various internal and external programs/services.

• Detect high-risk factors and service requirements, making suitable referrals.

• Organize and execute designated care-plan activities while monitoring progress.

• Present cases during case conferences for multidisciplinary evaluation.

• Recognize and escalate quality-of-care concerns.

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

• Employ motivational interviewing techniques to encourage member engagement and promote lifestyle/behavior changes.

• Mentor and empower members to make independent medical and healthy lifestyle decisions.

• Assist members in actively participating in healthcare decision-making with informed knowledge.

• Implement case-management processes in alignment with regulatory, accreditation, and company standards.

⛳️ Requirements

• Minimum of 2 years of experience in case management.

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

• Experience with the elderly population.

• Experience assisting members with physical disabilities.

• 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, or Counseling, or a valid Arizona RN (Registered Nurse) license.

• Excellent organizational and time management abilities.

• Capability to collaborate effectively with internal and external partners.

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

• Prior experience working collaboratively with medical professionals.

• Bilingual in English and Spanish is preferred.

🏝️ Benefits

• $5,000 sign-on bonus.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program (in addition to base pay).