Case Management Coordinator - Field Illinois (Southwest Cook County, IL) at CVS Health

Schaumburg, Illinois, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

2+ years experience in Behavioral Health, Social Services or appropriate related field equivalent to program focus
Must be willing and able to travel 50-75% of the time in Southwest Cook County, Illinois. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy
Must have 2+ years of experience of electronic documentation experience and Microsoft Office applications
Bachelor's degree or non-licensed master level clinician required with either degree being in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family therapy, Counseling)

Responsibilities

Through the use of care management tools and information/data review, conducts comprehensive evaluation of 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
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
Engages with colleagues in ongoing team meetings and offers peer mentoring/training
Helps member actively and knowledgably participate with their provider in healthcare decision-making
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Skills

Key technologies and capabilities for this role

Case ManagementCare CoordinationCritical ThinkingAppointment SchedulingBenefit NavigationHealthcare EvaluationRisk AssessmentCare PlanningMember OutreachMedical Appropriateness

Questions & Answers

Common questions about this position

Is this position remote or does it require travel?

This is a full-time telework position requiring 50-75% travel in Southwest Cook County, Illinois.

What are the working hours for this role?

The hours are Monday-Friday from 8:00am to 5:00pm Central Time.

What key skills are needed for the Case Management Coordinator role?

The role requires critical thinking and judgment, negotiation skills, influencing and motivational interviewing skills, and the ability to use care management tools for member evaluation and care planning.

What is the company culture like at CVS Health?

CVS Health emphasizes building a world of health with dedicated, purpose-driven colleagues who are passionate about transforming health care in a connected, convenient, and compassionate way.

What makes a strong candidate for this position?

Strong candidates will have experience in case management, the ability to conduct comprehensive member evaluations, coordinate care plans, use motivational interviewing to engage members, and collaborate in team settings.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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