Case Management Coordinator - Field Illinois (Chatham/South Shore Cook County)
CVS Health, Springfield, IL, United States
Location
Full‑time telework position requiring 50‑75% travel in and around the Chatham / Southshore area of Cook County, Illinois.
Schedule
Standard business hours Monday‑Friday 8:00am‑5:00pm CST.
Position Summary
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 providing assistance with appointment scheduling, identifying and assisting with accessing benefits, and educating members through the use of care management tools and resources.
Key Responsibilities
Evaluation of Members: Conduct comprehensive evaluation of member’s needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal 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 intervention as appropriate.
Coordinates and implements assigned care plan activities and monitors care plan progress.
Enhancement of Medical Appropriateness and Quality of Care: Using a 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 achieve 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 achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Engages with colleagues in ongoing team meetings and offers peer mentoring/training.
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.
Required Qualifications
2+ years experience in Behavioral Health, Social Services or appropriate related field equivalent to program focus.
Must be willing and able to travel 50‑75% of the time in Chatham/ Southshore and surrounding areas in Cook County, Illinois. Reliable transportation required. Mileage is reimbursed per company expense reimbursement policy.
Must have 2+ years of electronic documentation experience and Microsoft Office applications.
Preferred Qualifications
Case management and discharge planning experience.
Managed Care experience.
Education
Bachelor’s degree or non‑licensed master level clinician required with either degree being in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family Therapy, Counseling).
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
$21.10 - $44.99 per hour or equivalent base annual salary, with eligibility for bonus, commission or short‑term incentive programs.
Benefits
Comprehensive benefits package including medical, dental, vision coverage, paid time off, retirement savings options, wellness programs and other resources for eligible members and their families.
Equal Employment Opportunity
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Full‑time telework position requiring 50‑75% travel in and around the Chatham / Southshore area of Cook County, Illinois.
Schedule
Standard business hours Monday‑Friday 8:00am‑5:00pm CST.
Position Summary
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 providing assistance with appointment scheduling, identifying and assisting with accessing benefits, and educating members through the use of care management tools and resources.
Key Responsibilities
Evaluation of Members: Conduct comprehensive evaluation of member’s needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal 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 intervention as appropriate.
Coordinates and implements assigned care plan activities and monitors care plan progress.
Enhancement of Medical Appropriateness and Quality of Care: Using a 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 achieve 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 achieve optimum level of health.
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Engages with colleagues in ongoing team meetings and offers peer mentoring/training.
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.
Required Qualifications
2+ years experience in Behavioral Health, Social Services or appropriate related field equivalent to program focus.
Must be willing and able to travel 50‑75% of the time in Chatham/ Southshore and surrounding areas in Cook County, Illinois. Reliable transportation required. Mileage is reimbursed per company expense reimbursement policy.
Must have 2+ years of electronic documentation experience and Microsoft Office applications.
Preferred Qualifications
Case management and discharge planning experience.
Managed Care experience.
Education
Bachelor’s degree or non‑licensed master level clinician required with either degree being in Behavioral Health or Human Services (Psychology, Social Work, Marriage and Family Therapy, Counseling).
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
$21.10 - $44.99 per hour or equivalent base annual salary, with eligibility for bonus, commission or short‑term incentive programs.
Benefits
Comprehensive benefits package including medical, dental, vision coverage, paid time off, retirement savings options, wellness programs and other resources for eligible members and their families.
Equal Employment Opportunity
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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