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
Highly organized, remain self-drive without direct supervision
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
40Time Type
Full timePay Range
The typical pay range for this role is:
$21.10 - $36.78This 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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Job details are sourced from the employer's original posting.
Open job postingAbout the company
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.