Case Management Coordinator – Field – Montgomery, Fayette, or Shelby Counties Illinois at CVS Health

Shelbyville, Illinois, United States

Apply Now

Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

2+ years experience in behavioral health, social services, or a human services field
2+ years of case management experience
Must reside in Montgomery, Fayette, or Shelby Counties, IL or Surrounding Area
Must possess reliable transportation and be willing and able to travel up to 50-75% of the time in Montgomery, Fayette, or Shelby Counties, IL and surrounding areas
Bachelor's Degree in behavioral health or human services required (psychology, social work, marriage and family therapy, counseling)

Responsibilities

Conducts comprehensive evaluation of referred member’s needs/eligibility using care management tools and information/data review, recommends approach to case resolution/meeting needs by evaluating member’s benefit plan and available 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
Consults with case managers, supervisors, Medical Directors and/or other health programs using holistic approach to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review for 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 knowledgeably 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

Care Coordination

Case Management

Member Evaluation

Care Planning

Crisis Intervention

Multidisciplinary Collaboration

Healthcare Navigation

LTSS

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.

Land your dream remote job 3x faster with AI

Try Jobo Free