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Job description
CVS Health Case Management Position
We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, 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 Summary
Conducts routine care coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes for members. Helps implement projects, programs, and processes for Case Management. Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area.
A Brief Overview
Conducts routine care coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes for members. Helps implement projects, programs, and processes for Case Management. Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area.
What You Will Do
Consults with case managers, supervisors, medical directors and/or other health programs using a holistic approach, to overcome barriers to meeting goals and objectives.
Presents cases at case conferences to obtain a multidisciplinary review in order to achieve optimal outcomes.
Identifies and escalates quality of care issues through established channels.
Demonstrates negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
Delivers influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Assists in encouraging members to actively participate with their provider in healthcare decision-making.
Conducts comprehensive evaluations of referred members' needs/eligibility using care management tools and recommends an approach to case resolution.
For This Role You Will Need Minimum Requirements
*Must live in Louisiana Region 7 (Alexandria/Shreveport): Northwest parishes (Caddo, Bossier, Webster, Claiborne, Bienville, Red River, Desoto, Sabine, Natchitoches)
Degree in Health Care/Human Services related field
Case Management Experience
Strong customer service orientation and problem solving skills
Excellent communication/telephonic skills
Excellent motivational interviewing skills/ability to build rapport and trust telephonically
Excellence in documentation and respecting compliance/regulatory standards
Highly organized, remain self-driven without direct supervision
Manage time effectively
Achieve performance metrics
Technology proficiency
Ability to travel within 125 miles round trip for 1 day in the field
Variable work scheduled with ability to work 2 days weekly until 9pm local time
Preferred Qualifications
Bachelors and/or Master's Degree
CCM certification
Previous experience in managed care organization
Education
Degree in Health Care/Human Services related field required
Anticipated Weekly Hours: 40
Time Type: Full time
Pay Range: $21.10 - $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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base 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 people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Worksite address
covington, LA, 70435, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.