Healthcare Case Manager

6 days ago

Santa Cruz, California, United States CVS Health Full time
Transforming Patient Care with CVS Health

At CVS Health, we're committed to delivering exceptional patient care and outcomes. As a Case Management Coordinator, you'll play a vital role in elevating our patient care to new heights.

Key Responsibilities:
  • Evaluate members' needs and eligibility, recommending approaches to case resolution and meeting needs through care management tools and resources.
  • Identify high-risk factors and service needs that may impact member outcomes and care planning components, referring to clinical case management or crisis intervention as necessary.
  • Coordinate and implement assigned care plan activities, monitoring care plan progress.
  • Enhance medical appropriateness and quality of care by consulting with case managers, supervisors, Medical Directors, and other health programs to overcome barriers to meeting goals and objectives.
  • Identify and escalate quality of care issues through established channels.
  • Utilize negotiation skills to secure appropriate options and services necessary to meet members' benefits and healthcare needs.
  • Empower members to make independent medical and healthy lifestyle choices through coaching, information, and support.
Requirements:
  • 2+ years of experience in behavioral health or social services.
  • Ability to work 8:00a-5:00p in the assigned market time zone.
  • 2+ years of experience with Microsoft Office applications (Word, Excel, Outlook).
Preferred Qualifications:
  • Case management and discharge planning experience.
  • Managed Care experience.
Education:
  • Bachelor's degree or non-licensed master level clinician with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) or equivalent experience.

At CVS Health, we offer a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, and employee stock purchase plan. We're committed to creating a work environment that's inclusive, diverse, and supportive of our colleagues' well-being. Join us in our mission to transform patient care and make a meaningful difference in the lives of our members and communities.

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