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Job Details


CVS Health

Case Management Coordinator (2084889BR)

Pharmaceuticals

All

Yearly

No

Chicago, Illinois, United States

Job Description
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate
appropriate healthcare outcomes for members by providing care coordination, support and education for
members through the use of care management tools and
resources.Evaluation of Members: -Through the use of
care management tools and information/data review,
conducts comprehensive evaluation of referred member’s
needs/eligibility and recommends an approach to case
resolution and/or meeting needs by evaluating member’s
benefit plan and available internal and external
programs/services. Identifies 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. -
Coordinates and implements assigned care plan activities
and monitors care plan progress. Enhancement of Medical
Appropriateness and Quality of Care: - Using holistic
approach consults with case managers, supervisors,
Medical Directors and/or other health programs to
overcome barriers to meeting goals and objectives;
presents cases at case conferences to obtain
multidisciplinary review in order to achieve optimal
outcomes. - Identifies and escalates quality of care issues
through established channels. -Utilizes negotiation skills to
secure appropriate options and services necessary to
meet the member’s benefits and/or healthcare needs. -
Utilizes influencing/ motivational interviewing skills to
ensure maximum member engagement and promote
lifestyle/behavior changes to achieve optimum level of
health. -Provides coaching, information and support to
empower the member to make ongoing independent
medical and/or healthy lifestyle choices. -Helps member
actively and knowledgably participate with their provider in
healthcare decision-making. Monitoring, Evaluation and
Documentation of Care: - Utilizes case management and
quality management processes in compliance with
regulatory and accreditation guidelines and company
policies and procedures.

Required Qualifications
Minimum 2 years of experience in behavioral health, social services or human services field.
- Willing and able to travel up to 50-75% of their time using their own vehicle to meet members face to face in southern suburbs of cook county IL and surrounding areas.
-Valid Drivers License required.
-Qualified candidate must be located in southern suburbs of cook county.

COVID Requirements


COVID-19 Vaccination Requirement
CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
-Case management and discharge planning experience
-Managed Care experience
-Microsoft Office experience
-Waiver/LTSS or Home and community based services experience is highly preferred.

Education
Bachelor's degree with either degree being in Behavioral Health, social service or Human Services field of study required. A non-licensed Master level clinician with either degree being in Behavioral Health or a Human Services field of study preferred

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.