Case Manager

Alright, let's talk about this job. It's for a Case Management Coordinator with CVS Health's Aetna team in Columbus, OH. This isn't just paperwork; you're the person who helps connect the dots for members enrolled in both Medicare and Medicaid, folks who often have really complex health and social needs. You'll use your head to figure out what they need and then help make it happen.

What you'd be doing

You're evaluating members' situations using care management tools and data. That means looking at their benefit plans and figuring out the best path forward, whether that's using internal programs or finding external services.

• You'll spot high risk factors that could affect someone's health outcomes and know when to bring in a clinical case manager or a crisis intervention specialist.
• A big part of the job is coordinating the activities laid out in a care plan and keeping an eye on how things are progressing.
• You’ll consult with case managers, supervisors, and Medical Directors to work through any barriers. Sometimes you’ll present cases in team meetings to get different perspectives for the best outcome.
• If you see a quality of care issue, you know how to escalate it through the right channels.
• A lot of this is about communication and negotiation; securing the right services for members within their benefits and using motivational interviewing techniques to really engage them in their own health decisions.
• Your role is to coach and support members so they feel empowered to manage their health and make informed choices with their doctors.
• There's also a teamwork component; you'll be involved in regular meetings and might help train or mentor peers.
• And of course, all your work follows specific processes for documentation, quality management, and meets regulatory standards.

The essentials we need from you

We're looking for someone with at least two years of experience in behavioral health, social services, or a related field that fits the program's focus. You need a Bachelor's degree (or a non licensed Master's) in behavioral health or human services; think psychology, social work, marriage and family therapy, or counseling.

• You have to be confident working from home as an independent thinker but also skilled at using virtual tools to stay connected with your team.
• Strong analytical and problem solving skills are non negotiable. So are effective communication, organization, and interpersonal skills.
• You should be proficient with standard software: MS Word, Excel, Outlook, PowerPoint. You'll also learn some proprietary systems.
• General computer efficiency is key; you'll be navigating multiple systems and keyboarding throughout the day.
• This role requires travel; up to 50 75% of the time. You must have reliable transportation. Don't worry about gas money; mileage is reimbursed according to company policy.

A few things that would make you stand out

The team would love it if you were bilingual in English AND Cantonese or Mandarin. Any prior case management, discharge planning, or Managed Care experience is a huge plus here too.

The schedule & pay

This is a full time position at 40 hours per week. The typical pay range for this role is between $21.10 and $44.99 per hour. The actual offer will depend on several factors like your experience level, location within Columbus, OH, skillset… all those usual things that go into figuring out salary details during an interview process.

The fine print & how to apply

The pay range listed reflects base hourly rates for this job grade. Final compensation may vary based on individual qualifications.

To apply for this Case Management Coordinator position with CVS Health/Aetna in Columbus, OH, please submit your application through our official careers portal.