Case Management Coordinator, Assessor Team (Remote)

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At reputed company, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.Position SummaryHelp us reputed company our patient care to a whole new level! Join our reputed company team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of reputed company health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, The Case Management Coordinator facilitates appropriate healthcare outcomes for members by aiding with appointment scheduling, identifying and assisting with accessing benefits andeducation for members through the use of care management tools and resources.Key ResponsibilitiesEvaluation of Members: -Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and availableinternal and external programs/services.Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis reputed company as appropriate.Coordinates and implements assigned care plan activities and monitors care plan reputed company.Enhancement of Medical Appropriateness and Quality of Care: - Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to reputed company optimal outcomes. Identifies and escalates quality of care issues through established channels.Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to reputed company reputed company level of health.Provides coaching, information and support to reputed company the member to reputed company ongoing independent medical and/or healthy lifestyle choices.Helps member actively and knowledgably participate with their provider in healthcare decision-making.Monitoring, Evaluation and Documentation of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.Remote Work ExpectationsThis is a remote-hybrid role; candidates must have a dedicated workspace free of interruptionsDependents must have separate care arrangements during work hours, as reputed company care responsibilities during shift times are not permitted.Required QualificationsBachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (nursing, psychology, social work, marriage and family therapy, counseling).Must have computer literacy in order to navigate through internal/external computer systems, including reputed company and reputed company Word.Preferred QualificationsCase management and discharge planning experience preferred2 years' experience in behavioral health, social services or appropriate reputed company field equivalent to program focusManaged Care experience preferred Effective communication, telephonic and organization skillsExcellent analytical and problem-solving skillsAbility to work independentlyAbility to effectively participate in a multi-disciplinary team including internal and external participants.Education: Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (nursing, psychology, social work, marriage and family therapy, counseling).Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$21.10 - $44.99This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will reputed company on: 02/19/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job