Case Management Coordinator – Transition of Care Team

This is a fully remote position, open to applicants in Alabama, +22 more states.

📋 Description

• Assess the needs and eligibility of referred members utilizing care management tools and data analysis.

• Suggest case-resolution strategies and evaluate benefit plans along with internal and external programs and services.

• Recognize high-risk factors and service requirements that impact member outcomes and care planning.

• Refer members to clinical case management or crisis intervention services when necessary.

• Coordinate, implement, and oversee activities related to the assigned care plan.

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

• Present cases at multidisciplinary case conferences.

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

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

• Utilize motivational interviewing techniques to engage members and encourage lifestyle or 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.

• Monitor, assess, and document care in accordance with regulatory, accreditation, and company standards.

⛳️ Requirements

• A minimum of 2 years of experience in behavioral health or social services.

• Ability to work from 8:00 AM to 5:00 PM in the designated market time zone.

• At least 2 years of experience with Microsoft Office Applications (Word, Excel, Outlook).

• A dedicated workspace that is free from interruptions.

• Alternative care arrangements for dependents during work hours.

• Experience in case management and discharge planning is preferred.

• Managed care experience is also preferred.

• A Bachelor's Degree or a non-licensed master's level clinician degree in behavioral health or human services is preferred, or equivalent experience is required.

• A direct or hardwired internet connection to a modem/router within 7 feet of the computer.

• Minimum internet speed of 25 Mbps download and 3 Mbps upload is required.

• WiFi and satellite internet connections are not allowed.

• A quiet, secure, and private designated home virtual workspace that complies with CVS Health and HIPAA regulations.

• Ability to work within the state and city where the candidate resides.

• Experience with Microsoft Office 365 applications or similar Google Workspace tools.

• Competency in navigating multiple monitors and applications.

• Proficiency in using email, calendar invites, Teams messaging, and virtual meetings.

• Capability to log into secure systems such as VPN and EHR portals.

• Ability to maintain strong passwords and identify suspicious emails or links.

• Aptitude for independently troubleshooting common technical issues.

🏝️ Benefits

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

• Health 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.

• Company-provided equipment, which includes a keyboard, monitor, computer, and headset.