Population Health and Wellness Care Management Coordinator

1 week ago


Frankfort, Kentucky, United States CVS Health Full time
Job Summary

CVS Health is seeking a Population Health and Wellness Care Management Coordinator to join our team. As a key member of our care management team, you will play a critical role in supporting the care management process to facilitate and maintain improved healthcare outcomes for members.

Key Responsibilities
  • Utilize critical thinking and professional judgment to support the case management process.
  • Provide advocacy, collaboration, coordination, support, and education for members through the use of care management tools and resources.
  • Evaluate members' benefit plans and available internal and external programs/services to identify high-risk factors and service needs that may impact member outcomes.
  • Implement early and proactive support interventions to enhance medical appropriateness and quality of care.
  • Collaborate with case managers, supervisors, Medical Directors, and other health programs to overcome barriers to meeting goals and objectives.
  • Presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes.
  • Identify and escalate quality of care issues through established channels.
  • Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
  • Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
  • Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
  • Help members actively and knowledgeably participate with their provider in healthcare decision-making.
  • Monitor, evaluate, and document care to ensure compliance with regulatory and accreditation guidelines and company policies and procedures.
Requirements
  • Minimum of 2 years' experience in behavioral health, social services, or a related field equivalent to program focus.
  • Computer literacy and demonstrated proficiency in navigating internal/external computer systems and MS Office Suite applications, including Word and Excel.
  • Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, as needed.
Preferred Qualifications
  • Knowledge of growth and developmental milestones.
  • Case management experience.
  • Discharge planning experience.
  • Managed Care experience.
Education

Minimum of a Bachelor's degree or a non-licensed master level clinician in behavioral health or a relevant human services field of study (social work, psychology, marriage and family therapy, counseling).

Pay Range

The typical pay range for this role is $36.78. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors, including experience, education, geography, and other relevant factors.



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