Case Management Coordinator – Field

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

📋 Description

• Perform thorough evaluations of members' needs and eligibility utilizing care management tools alongside information and data analysis.

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

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

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

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

• Present cases during case conferences for multidisciplinary evaluation.

• Identify and escalate quality-of-care concerns through the appropriate 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 and behavior modifications.

• Offer coaching, information, and support to empower members towards independent medical and healthy lifestyle decisions.

• Participate in team meetings and provide peer mentoring and training.

• Assist members in engaging knowledgeably with providers in healthcare decision-making.

• Implement case management and quality management procedures in alignment with regulatory, accreditation, and company standards.

⛳️ Requirements

• A minimum of 2 years of experience in Behavioral Health, Social Services, or a related field relevant to program focus.

• Willingness and capability to travel 50-75% of the time within Lake, McHenry, and Northern Cook Counties in Illinois.

• Reliable transportation is a must.

• At least 2 years of experience in electronic documentation.

• Proficiency with Microsoft Office applications.

• A Bachelor's degree or a non-licensed master's level clinician degree in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family Therapy, Counseling) is required.

• Experience in case management and discharge planning is preferred.

• Managed Care experience is preferred.

🏝️ Benefits

• Mileage reimbursement in accordance with our company expense reimbursement policy.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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

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