CVS Health Case Management Coordinator- Central Cook County IL in Forest Park, Illinois
As a Case Management Coordinator you will facilitate appropriate healthcareoutcomes for members by providing care coordination, support and education formembers through the use of care management tools and resources.Travel: 50-75% travel required in Central Chicago IL and surrounding areas.Evaluation of Members:-Through the use of care management tools and information/data review, conductscomprehensive evaluation of referred member’s needs/eligibility and recommends anapproach to case resolution and/or meeting needs by evaluating member’s benefitplan and available internal and external programs/services. Identifies high risk factorsand service needs that may impact member outcomes and care planning componentswith appropriate referral to clinical case management or crisis intervention asappropriate.- Coordinates and implements assigned care plan activities and monitors care planprogress.Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with case managers, supervisors, Medical Directorsand/or other health programs to overcome barriers to meeting goals and objectives;presents cases at case conferences to obtain multidisciplinary review in order toachieve optimal outcomes.- Identifies and escalates quality of care issues through established channels.-Utilizes negotiation skills to secure appropriate options and services necessary tomeet the member’s benefits and/or healthcare needs.- Utilizes influencing/ motivational interviewing skills to ensure maximum memberengagement and promote lifestyle/behavior changes to achieve optimum level ofhealth.-Provides coaching, information and support to empower the member to make ongoingindependent medical and/or healthy lifestyle choices.-Helps member actively and knowledgeably participate with their provider in healthcaredecision-making.Monitoring, Evaluation and Documentation of Care:- Utilizes case management and quality management processes in compliance withregulatory and accreditation guidelines and company policies and procedures.This position is Non-Exempt.
- 2 years experience in behavioral health, social services or human services field.- Must be willing and able to travel using your own vehicle 50-75% of their time to meet members face to face in Central cook county IL, Central Chicago, Chicago Downtown and surrounding areas.-Valid Driver's License Required.
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
- Case management and discharge planning experience - Managed Care experience preferred- Microsoft Office experience preferred
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling)
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.