CVS Health
Case Management Coordinator- Field - Salt River Trail-Kentucky
CVS Health, Frankfort, Kentucky, United States, 40601
Case Management Coordinator- Field - Salt River Trail-Kentucky
At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose‑driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary This is a telework position with 80-90% travel in the Salt River Trail Region of Kentucky. Qualified candidates must reside in one of 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 judgement 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 a 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
Evaluation of Members:
Conduct comprehensive assessment of member’s needs/eligibility and recommend 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. Identify 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.
Coordinate and implement assigned care plan activities and monitor/ update care plan to reflect progress that supports optimal member health, wellness and compliance with juvenile justice system guidelines.
Collaborate with partners from the state and behavioral health systems to ensure that the member understands their health care needs.
Enhancement of Medical Appropriateness and Quality of Care:
Consult with case managers, supervisors, Medical Directors and other health programs to overcome barriers to meeting goals and objectives; present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
Identify and escalates quality of care issues through established channels.
Utilize negotiation and influencing/motivational interviewing skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs, and promote lifestyle/behavior changes.
Provide coaching, information and support to empower the member to make independent medical and healthy lifestyle choices, and help member actively participate with their provider in healthcare decision‑making.
Monitor, evaluate and document care, utilizing case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
Residency in one of the listed Kentucky counties.
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, 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.
Reliable transportation and willingness to travel 80‑90% of the time to meet members face‑to‑face in the Salt River Trail service region (mileage reimbursed per company policy).
Flexibility to work beyond core business hours Monday‑Friday 8 am‑5 pm, as required.
Preferred Qualifications
Knowledge of growth and developmental milestones.
Care management experience.
Discharge planning experience.
Managed Care experience.
Education
Minimum bachelor’s degree or non‑licensed master level clinician in behavioral health, social work, psychology, marriage and family therapy, counseling or related field.
Anticipated Weekly Hours 40 hours per week.
Time Type Full time.
Pay Range $21.10 – $36.78 per hour (base hourly rate). Eligible for CVS Health bonus, commission or short‑term incentive program in addition to the base pay range.
Great Benefits For Great People
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No‑cost programs for all colleagues: wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions to address different needs and preferences: paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits.
We anticipate the application window for this opening will close on: 11/14/2025.
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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Position Summary This is a telework position with 80-90% travel in the Salt River Trail Region of Kentucky. Qualified candidates must reside in one of 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 judgement 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 a 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
Evaluation of Members:
Conduct comprehensive assessment of member’s needs/eligibility and recommend 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. Identify 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.
Coordinate and implement assigned care plan activities and monitor/ update care plan to reflect progress that supports optimal member health, wellness and compliance with juvenile justice system guidelines.
Collaborate with partners from the state and behavioral health systems to ensure that the member understands their health care needs.
Enhancement of Medical Appropriateness and Quality of Care:
Consult with case managers, supervisors, Medical Directors and other health programs to overcome barriers to meeting goals and objectives; present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
Identify and escalates quality of care issues through established channels.
Utilize negotiation and influencing/motivational interviewing skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs, and promote lifestyle/behavior changes.
Provide coaching, information and support to empower the member to make independent medical and healthy lifestyle choices, and help member actively participate with their provider in healthcare decision‑making.
Monitor, evaluate and document care, utilizing case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
Residency in one of the listed Kentucky counties.
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, 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.
Reliable transportation and willingness to travel 80‑90% of the time to meet members face‑to‑face in the Salt River Trail service region (mileage reimbursed per company policy).
Flexibility to work beyond core business hours Monday‑Friday 8 am‑5 pm, as required.
Preferred Qualifications
Knowledge of growth and developmental milestones.
Care management experience.
Discharge planning experience.
Managed Care experience.
Education
Minimum bachelor’s degree or non‑licensed master level clinician in behavioral health, social work, psychology, marriage and family therapy, counseling or related field.
Anticipated Weekly Hours 40 hours per week.
Time Type Full time.
Pay Range $21.10 – $36.78 per hour (base hourly rate). Eligible for CVS Health bonus, commission or short‑term incentive program in addition to the base pay range.
Great Benefits For Great People
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No‑cost programs for all colleagues: wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions to address different needs and preferences: paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits.
We anticipate the application window for this opening will close on: 11/14/2025.
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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