Case Management Coordinator – Transition of Care Team

This is a fully remote position, open to applicants in Alabama, +11 more states.

📋 Description

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

• Suggest strategies for case resolution and fulfilling members' requirements.

• Recognize high-risk factors and service needs that influence outcomes and care planning.

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

• Coordinate and execute the activities outlined in the assigned care plan.

• Track the progress of care plans.

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

• Present cases during multidisciplinary case conferences.

• Identify and escalate issues related to quality of care.

• Negotiate suitable options and services that benefit members and meet their healthcare needs.

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

• Provide coaching, information, and support for independent medical and healthy lifestyle choices.

• Assist members in making informed healthcare decisions in collaboration with providers.

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

• Schedule appointments and help members access benefits, education, and services.

⛳️ 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.

• Separate care arrangements for dependents during working hours.

• Preferred experience in case management and discharge planning.

• Preferred experience in managed care.

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

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

• Minimum internet speeds of 25 Mbps for download and 3 Mbps for upload.

• WiFi and satellite internet connections are not permitted.

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

• Ability to work within the state and city of current residence.

• Proficiency in setting up and using multiple monitors and navigating various applications.

• Effective communication skills via email, calendar invites, Teams messaging, and virtual meetings.

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

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

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

• Competence in independently resolving common technical issues.

• Willingness to learn new skills as the workplace evolves.

🏝️ Benefits

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

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Other resources that support physical, emotional, and financial well-being.

• Company-provided equipment (keyboard, monitor, computer, headset, etc.).