Case Management Coordinator – Field
| Company | CVS Health |
|---|---|
| Location | Rockford, IL, USA, Davenport, IA, USA |
| Salary | $21.1 – $44.99 |
| Type | Full-Time |
| Degrees | |
| Experience Level | Mid Level |
Requirements
- Minimum 2 years of experience in behavioral health, social services or human services field.
- Minimum 2 years of case Management experience.
- Must reside in Rock Island County IL or Surrounding Areas.
- Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet members face to face in Rock Island County IL and surrounding areas.
Responsibilities
- Facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
- Conduct comprehensive evaluation of referred member’s needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
- Identify high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
- Coordinate and implement assigned care plan activities and monitor care plan progress.
- Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
- Identify and escalate quality of care issues through established channels.
- Utilize negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
- Utilize influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
- Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
- Help member actively and knowledgeably participate with their provider in healthcare decision-making.
- Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Preferred Qualifications
- Case management and discharge planning experience
- Managed Care experience
- Microsoft Office experience