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Position Summary This is a telework position with 80-90% travel in the Salt River Trail Region of Kentucky. Qualified candidates must reside in or adjacent to the following counties: Breckinridge, Grayson, Meade, Hardin, Larue, Bullitt, Nelson, Marion, Washington, Spencer, Anderson, Woodford, Shelby, Franklin, Henry, Oldham, and Trimble.

The Care Management Coordinator (CMC) utilizes critical thinking and clinical judgment to collaborate and implement the case management process, in order to facilitate appropriate physical and behavioral healthcare outcomes for members by providing advocacy, care coordination, support and education for members through the use of care management tools and resources.

This position is field-based and requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training.

Responsibilities include:

• Evaluation of Members:

• Through the use of care management tools and information/data review, conducts comprehensive assessment of member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs, including their legal, educational and biopsychosocial needs by evaluating member’s benefit plan and available internal and external resources. 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/updates care plan to reflect progress that supports the optimal member health, wellness and compliance with juvenile justice system guidelines.

• Collaborates with partners from the state and behavioral health systems to ensure that the member understand their health care needs.

• 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 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 and wellbeing.

• Provides coaching, information and support to empower the member to make 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.

Required Qualifications

• Qualified candidates must reside in or adjacent to the following counties: Breckinridge, Grayson, Meade, Hardin, Larue, Bullitt, Nelson, Marion, Washington, Spencer, Anderson, Woodford, Shelby, Franklin, Henry, Oldham, and Trimble.

• 2 years’ experience in behavioral health, social services, or human services field.

• 1+ year(s) of experience with Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations

• 1 year experience with MS Office Suite applications, including Word and Excel.

• Must have reliable transportation and be willing and able to travel 80-90% of the time to meet members face to face in Salt River Trail Service region (Breckinridge , Grayson, Meade, Hardin, Larue, Bullitt, Nelson, Marion, Washington, Spencer, Anderson, Woodford, Shelby, Franklin, Henry, Oldham, Trimble ). Mileage will be reimbursed per company policy.

• Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, is required, as we are serving the needs of children and families that may require working after school, after work, etc.

Preferred Qualifications

• Knowledge of growth and developmental milestones.

• Care management experience

• Discharge planning experience

• Managed Care experience

Education

• Minimum of a bachelor's degree or a non-licensed master level clinician is required with either degree being in behavioral health, or a relevant human services field of study (social work, psychology, marriage and family therapy, counseling) required.

Pay Range

The typical pay range for this role is:

$19.52 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 06/30/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.