Case Management Coordinator

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

📋 Description

• Perform thorough assessments of referred members' needs and eligibility utilizing care management tools and data analysis.

• Suggest strategies for case resolution and satisfying member needs by reviewing benefit plans and available programs/services.

• Recognize high-risk factors and service requirements, referring members to clinical case management or crisis intervention as necessary.

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

• Collaborate with case managers, supervisors, Medical Directors, and other health programs to address barriers.

• Present cases in case conferences for multidisciplinary evaluation.

• Identify and report quality-of-care concerns through established channels.

• Negotiate suitable options and services to meet members' benefits and healthcare requirements.

• Utilize influencing and motivational interviewing techniques to engage members and encourage lifestyle/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 and quality management processes in accordance with regulatory, accreditation, and company standards.

• Communicate with members/clients via phone or in person and deliver ongoing case management services at homes, worksites, or physician offices when necessary.

⛳️ Requirements

• Must live in the state of Illinois.

• Must have reliable transportation.

• Must be willing and able to travel up to 40% of the time from the candidate’s home base.

• Proficient in computer skills, including navigating internal/external systems, Excel, and Microsoft Word.

• Strong communication, telephonic, and organizational abilities.

• Exceptional analytical and problem-solving skills.

• Capability to work independently.

• Ability to effectively collaborate within multidisciplinary teams.

• Minimum of 2 years’ experience in behavioral health, social services, or a related field relevant to the program focus.

• Preferred experience in case management and discharge planning.

• Preferred experience in Managed Care.

• Bilingual skills are preferred.

• Bachelor’s degree or a non-licensed master-level clinician credential is required, with either degree in behavioral health or human services, such as nursing, psychology, social work, marriage and family therapy, or counseling.

• Must have a dedicated workspace free from interruptions.

• Dependents must have separate care arrangements during work hours.

• Must be capable of interacting with members/clients via phone or in person.

🏝️ Benefits

• Mileage reimbursement according to the company expense reimbursement policy.

• 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.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.