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CVS Health

Runs pharmacies, health plans and clinics

Case Management Coordinator Analyst

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • At least 6 months of experience in foster care and juvenile justice systems, adoption assistance, behavioral health services, trauma-informed care, Adverse Childhood Experiences (ACEs), crisis intervention services, or evidence-based practices applicable to Kentucky SKY populations.
  • At least 2 years of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
  • At least 1 year of experience with Microsoft Office Suite applications, including Word and Excel.
  • Willingness and ability to travel 80–90% of the time to meet members face to face in the assigned region.
  • Must reside in Jefferson County.
  • A bachelor's or master's degree in behavioral health or a relevant human services field of study, such as social work, psychology, marriage and family therapy, or counseling.

Responsibilities

  • Evaluate member care needs using care management assessments and information and data review, considering the member’s benefit plan and available internal and external programs and services.
  • Identify high-risk factors and service needs that may affect member outcomes, and implement early, proactive support interventions.
  • Coordinate and implement wellness care plan activities and monitor member care needs.
  • Consult with case managers, supervisors, Medical Directors, and other health programs to address barriers to goals and objectives, and present cases at case conferences for multidisciplinary review.
  • Identify and escalate quality-of-care issues through established channels.
  • Use negotiation skills to secure appropriate options and services that meet members’ benefits or healthcare needs.
  • Use influencing and motivational interviewing skills to support member engagement and promote lifestyle and behavior changes.
  • Provide coaching, information, and support to empower members to make ongoing independent medical and healthy lifestyle choices.
  • Help members participate actively and knowledgeably with their providers in healthcare decision-making.
  • Use case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
  • Travel to members’ homes, schools, hospitals, doctors’ offices, and DCBS offices for face-to-face visits; travel to the Louisville office for meetings and training.

Desired Qualifications

  • At least 3 years of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
  • At least 1 year of managed care organization (MCO) experience.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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