Experienced Care Management Coordinator - Remote Work Opportunity in Oklahoma with CVS Health, Utilizing Comprehensive Care Management and Coordination Skills to Drive Success

Introduction to CVS Health and Our Mission

At CVS Health, we are driven by a singular, clear purpose: to bring our heart to every moment of your health. This purpose guides our commitment to delivering enhanced, human-centered healthcare for a rapidly changing world. Embedded in our brand – with the heart at its center – our mission sends a personal message that how we deliver our services is just as important as what we deliver. Our "Heart At Work Behaviors" supports this mission, empowering every individual who works at CVS Health to feel enabled by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.

About the Role: Care Management Coordinator

This is a full-time, field-based telecommuter opportunity in Oklahoma, where you will be responsible for ensuring the operation of care management and care coordination activities across the continuum of care. As a Care Management Coordinator, you will utilize critical thinking and judgment to collaborate and inform the care management/care coordination process, facilitating appropriate healthcare outcomes for individuals by providing care coordination, support, and education. Your role will involve working with individuals, families, and healthcare providers to develop and implement comprehensive care plans, addressing the physical, emotional, and social needs of our members.

Key Responsibilities:

• Utilize care management tools and data through information review to conduct a comprehensive assessment of referred member's needs/eligibility and recommend an approach to case resolution or address needs by assessing member's benefit plan and available internal and external programs/services.
• Identify high-risk factors and service needs that may impact member outcomes and care planning, referring members to clinical case management or crisis intervention as appropriate.
• Coordinate and execute assigned care plan activities and monitor care plan progress, using a holistic approach to consult with clinical care managers, leadership, clinical directors, and/or other health/behavioral health programs to overcome barriers to meeting objectives and targets.
• Present cases at case conferences to obtain multidisciplinary reviews to achieve optimal outcomes, working collaboratively with the member's interdisciplinary care team to identify and escalate quality of care issues through established channels.
• Use negotiation skills to secure appropriate choices and services necessary to meet the member's benefits or potential healthcare needs, and influencing/persuasive speaking skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve an optimal level of health.
• Provide instructions, information, and support to empower the member to make ongoing, informed clinical or healthy lifestyle decisions, assisting members to actively and knowledgeably participate with their provider in healthcare navigation.
• Serve as a single point of contact for members, helping members to remediate immediate and acute gaps in care and access, and screening, assessing, and documenting care using case management and quality management processes in accordance with regulatory and licensure rules and company policies and procedures.
• Identify, refer, and connect members to providers and social supports on a case-by-case basis (e.g., scheduling appointments, coordinating transportation), educating members about available resources and services, such as Oklahoma values-added benefits, and helping the member access those resources and services.
• Work with clinical handoffs during transitions of care, ensuring seamless coordination and continuity of care.

Essential Qualifications:

To be successful in this role, you should reside in Oklahoma and have at least 2 years of related professional experience, including acting as a care manager, rehabilitation specialist, health educator, or social service facilitator. You should also have the ability to complete the Behavioral Health Caseworker certificate training provided through the Department of Mental Health and Substance Abuse Services within at least 6 months of the hire date. Additionally, you should have 2+ years of experience using a computer, keyboard navigation, navigating multiple systems and applications, and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.). A reliable means of transportation and a willingness to travel in-state up to 30% of the time are also required, with mileage reimbursed per our company's expense reimbursement policy. You should be able to provide on-call CM coverage to evenings and weekends on a rotational schedule as required by the State regulatory agency.

Preferred Qualifications:

• Case management and discharge planning experience are preferred, as well as managed care experience.
• Experience working with Native American/Native Alaskan/American Indian populations is also preferred.

Education:

A minimum of a bachelor's degree in social work, psychology, or a related social service field, or an unlicensed master's prepared behavioral health clinician, is required for this role.

Skills and Competencies:

To excel in this position, you should possess strong critical thinking, problem-solving, and communication skills, with the ability to work collaboratively with interdisciplinary teams and navigate complex systems and processes. You should also be able to demonstrate a strong commitment to our mission and values, with a passion for delivering high-quality, patient-centered care.

Career Growth Opportunities and Learning Benefits:

At CVS Health, we are committed to supporting the growth and development of our employees, offering a range of training and development opportunities to help you build your skills and advance your career. As a Care Management Coordinator, you will have the opportunity to work with a talented team of professionals, developing and implementing innovative solutions to improve healthcare outcomes and enhance the patient experience.

Work Environment and Company Culture:

Our company culture is built on a foundation of respect, integrity, and compassion, with a strong commitment to diversity, equity, and inclusion. We believe in fostering a positive and supportive work environment, where every employee feels valued, empowered, and able to contribute their best work. As a remote worker, you will be an integral part of our team, working collaboratively with colleagues across the country to achieve our mission and vision.

Compensation, Perks, and Benefits:

We offer a competitive salary range of $26-$35 per hour, reflecting our commitment to attracting and retaining top talent. In addition to your salary, you will be eligible for a range of benefits, including medical, dental, and vision insurance, 401(k) matching, and paid time off. You will also have access to a range of perks and discounts, including employee discounts on CVS Health products and services, and opportunities for professional development and growth.

Conclusion:

If you are a motivated and compassionate professional, passionate about delivering high-quality, patient-centered care, we encourage you to apply for this exciting opportunity. As a Care Management Coordinator with CVS Health, you will have the chance to make a real difference in the lives of our members, working collaboratively with a talented team of professionals to drive innovation and excellence in healthcare. Don't miss out on this opportunity to join our team and take your career to the next level – apply today!