Case Management Coordinator - Adams County IL - Quincy - 62301

b'Job DescriptionnAs a Case Management Coordinator you will utilize critical thinking and judgment to collaborate and complete the case management process. You will facilitate appropriate healthcare outcomes for members by providing care coordination, support and education through the use of care management tools and resources.nnThis is a field-based position that will require 50-75% travel within the Adams, Brown, Pike, Schuyler and Hancock counties in IL and surrounding areas.nnEvaluation of Members:n-Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred memberxe2x80x99s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating memberxe2x80x99s benefit plan and available internal and external programs/servicesnxe2x80x93 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 appropriatenxe2x80x93 Coordinates and implements assigned care plan activities and monitors care plan progressnnEnhancement of Medical Appropriateness and Quality of Care:nxe2x80x93 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 achieve optimal outcomesnxe2x80x93 Identifies and escalates quality of care issues through established channelsnxe2x80x93 Utilizes negotiation skills to secure appropriate options and services necessary to meet the memberxe2x80x99s benefits and/or healthcare needs.nxe2x80x93 Utilizes influencing/ motivational interviewing skills tonensure maximum member engagement and promotenlifestyle/behavior changes to achieve optimum level ofnhealthnxe2x80x93 Provides coaching, information and support tonempower the member to make ongoing independentnmedical and/or healthy lifestyle choicesnxe2x80x93 Helps member actively and knowledgeably participate with their provider in healthcare decision-makingnnMonitoring, Evaluation and Documentation of Care:nxe2x80x93 Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.nnRequired Qualificationsnxe2x80x93 2 years experience in behavioral health, social services or appropriate related field equivalent to program focusnn-Proficiency with Microsoft Office suitennxe2x80x93 Must be comfortable completing field based travel to meet with Memebers, 50-75% travel required in Adams, Brown, Pike, Schuyler and Hancock counties in IL and surrounding areas.nnCOVID RequirementsnCOVID-19 Vaccination RequirementnCVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.nn * If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.nn * If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.nnPreferred Qualificationsnxe2x80x93 Case management and discharge planning experience preferred.nxe2x80x93 Managed Care experience preferred.nnEducationnBachelorxe2x80x99s degree or non-licensed master level cliniciannrequired, with either degree being in behavioral health or human services preferred (psychology, social work,nmarriage and family therapy, counseling)nnBusiness OverviewnAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.nnnWe are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.nApply ['