SKY Population Health and Wellness Care Manager - Must live near Louisville, KY

at  CVS Health

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

SUMMARY/POSITION OBJECTIVES:

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.
Aetna Better Health is hiring for multiple openings across the state/regions of Kentucky. Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, in order to facilitate and maintain improved healthcare outcomes for members by providing advocacy, collaboration coordination, support and education for members through the use of care management tools and resources.
This is a telework position that requires regional in-state travel 80-90% of the time. Qualified candidate must have reliable transportation. Travel to the Louisville office for meetings and training is also anticipated. This position is assigned to the Jefferson County. Qualified candidates may reside in or adjacent to the assigned region.
Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm CST, is required. We are serving the needs of children and families that may require working after school, after work, etc.

REQUIRED QUALIFICATIONS:

• Candidate must reside in or adjacent to Louisville, KY.
• Ability to travel 10-15% of the time
• Minimum 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY populations, is required.
• Minimum 1 year of experience required in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
• Minimum 1 year of experience in MS Office Suite applications, including Word and Excel.
• 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:

• 2 years’ experience in behavioral health, social services, or appropriate related field equivalent to program focus

EDUCATION AND CERTIFICATION REQUIREMENTS:

• 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)

• Consults with case managers, supervisors, medical directors and/or other health programs using a holistic approach.
• 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.