Case Management Coordinator – Field

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

📋 Description

• Facilitate favorable healthcare outcomes for members by managing appointment scheduling, accessing benefits, and providing member education.

• Assess member needs, determine eligibility, analyze benefit plans, and identify available programs or services.

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

• Coordinate activities outlined in care plans and track their progress effectively.

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

• Present cases during multidisciplinary case conferences for comprehensive review.

• Identify and escalate issues related to quality of care.

• Negotiate suitable options and services on behalf of members.

• Employ influencing and motivational interviewing techniques to engage members and encourage lifestyle or behavioral modifications.

• Offer coaching, resources, and support for making independent medical and healthy lifestyle choices.

• Engage in team meetings and contribute to peer mentoring and training initiatives.

• Assist members in becoming informed participants in healthcare decision-making.

• Implement case management and quality management processes while adhering to regulatory, accreditation, and company guidelines.

⛳️ Requirements

• A minimum of 2 years of experience in behavioral health, social services, or a relevant field aligned with program focus.

• Willingness and ability to travel 50-75% of the time within the Metro East area of IL.

• Reliable transportation is necessary.

• At least 2 years of experience in electronic documentation and proficiency in Microsoft Office applications.

• A Bachelor's degree or a non-licensed master's level clinician is required, with a degree in behavioral health or human services (psychology, social work, marriage and family therapy, counseling).

• Previous experience in case management and discharge planning is preferred.

• Managed Care experience is desirable.

🏝️ Benefits

• Mileage reimbursement according to our company expense reimbursement policy.

• Opportunity for CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Comprehensive medical coverage.

• Dental coverage options available.

• Vision insurance provided.

• Paid time off offered.

• Retirement savings options available.

• Wellness programs to support overall health.

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