Case Management Coordinator- Field- Northern Bluegrass Region KY

The Case Management Coordinator will utilize critical thinking and professional judgment to support the case management process, aiming to improve member healthcare outcomes through advocacy, collaboration, coordination, support, and education. This involves evaluating member benefit plans and available programs, identifying high-risk factors, and implementing proactive interventions. The role includes coordinating wellness care plan activities, monitoring member needs, and consulting with case managers, supervisors, Medical Directors, and other health programs to overcome barriers. Responsibilities also encompass identifying and escalating quality of care issues, negotiating for necessary options and services, utilizing motivational interviewing skills for member engagement, and empowering members to make informed healthcare and lifestyle choices. The coordinator will ensure compliance with regulatory and accreditation guidelines, company policies, and procedures through diligent documentation and case management processes. This is a telework position requiring 80-90% in-state travel within the assigned region, with occasional travel to Louisville for meetings and training.