Case Management Coordinator – Field

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

📋 Description

• Perform thorough assessments of members’ needs and eligibility through the use of care management tools and data analysis.

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

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

• Oversee assigned care-plan activities and track their progress.

• Collaborate with case managers, supervisors, Medical Directors, and other health programs to address 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 fulfill members’ benefits and healthcare requirements.

• Utilize motivational interviewing and influencing techniques to engage members and encourage healthy lifestyle modifications.

• Guide, educate, and assist members in making autonomous medical and healthy lifestyle decisions.

• Participate in team meetings and offer peer mentoring/training.

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

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

⛳️ Requirements

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

• Willingness and capability to travel 50-75% of the time within Cook County, Illinois.

• Reliable transportation is mandatory.

• Mileage reimbursement is in accordance with the company’s expense reimbursement policy.

• At least 2 years of experience with electronic documentation.

• Proficiency in Microsoft Office applications is required.

• A Bachelor’s degree or a non-licensed master’s level clinician is necessary.

• The degree must be in Behavioral Health or Human Services, including Psychology, Social Work, Marriage and Family Therapy, or Counseling.

• Experience in case management and discharge planning is preferred.

• Managed Care experience is also preferred.

🏝️ Benefits

• Mileage reimbursement in accordance with the company's expense reimbursement policy.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial wellbeing, based on eligibility.

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