Intensive Case Management Coordinator - Must live near Jefferson County, Kentucky at CVS Health

Jeffersontown, Kentucky, United States

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Not SpecifiedCompensation

Junior (1 to 2 years), Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Minimum of 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs (Adverse Childhood Experience), Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY (Supporting Kentucky Youth) populations
Minimum of 1 year of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling
Minimum of 1 year of experience in Microsoft Office Suite applications, including Word and Excel
Willing and able to travel 80-90% of the time to meet members face-to-face in the assigned region (Jefferson County, Kentucky)
Candidate must reside in or adjacent to Jefferson County, Kentucky
Must have reliable transportation
Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm EST (e.g., after school, after work)

Responsibilities

Evaluate members through care management assessments and data review to recommend approaches for resolving care needs, maintaining optimal health and well-being, evaluating benefit plans, and identifying high-risk factors for proactive interventions
Coordinate and implement Wellness care plan activities and monitor member care needs
Consult with case managers, supervisors, Medical Directors, and others using a holistic approach to overcome barriers, present cases at conferences for multidisciplinary review, and achieve optimal outcomes
Identify and escalate quality of care issues through established channels
Utilize negotiation skills to secure appropriate options and services meeting member benefits and healthcare needs
Use influencing/motivational interviewing skills to ensure member engagement, promote lifestyle/behavior changes, provide coaching, information, and support for independent medical and healthy lifestyle choices
Help members actively and knowledgably participate with providers in healthcare decision-making
Utilize case management and quality management processes in compliance with regulatory, accreditation guidelines, and company policies for monitoring, evaluation, and documentation of care

Skills

Case Management

Care Coordination

Health Assessments

Risk Assessment

Member Advocacy

Benefit Plan Evaluation

Wellness Programs

Critical Thinking

Professional Judgment

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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