Job Description:
• Conduct comprehensive assessments to evaluate member needs, eligibility, barriers to care, and opportunities for intervention
• Provide routine care coordination, support, and education to members to improve health outcomes
• Utilize motivational interviewing techniques to increase member engagement and promote healthy lifestyle changes
• Empower members to make informed healthcare decisions and actively participate in care plans
• Collaborate with case managers, supervisors, medical directors, providers, and other healthcare professionals
• Present cases at interdisciplinary case conferences to support optimal member outcomes
• Identify and escalate quality of care concerns through established channels
• Assist members in accessing appropriate services, benefits, and community resources
• Negotiate to secure services and support necessary to meet member needs
• Maintain accurate, timely, and compliant documentation of case management activities
• Meet productivity, quality, and performance metrics while managing a diverse caseload
• Support implementation of case management programs, projects, policies, and processes
• Utilize technology and multiple systems for member care and documentation
• Manage workload independently while maintaining organizational priorities and deadlines
Requirements:
• Minimum of two (2) years of experience in case management, behavioral health, social services, healthcare, or a related field
• Experience working with adult and/or adolescent populations
• Strong customer service orientation with excellent problem-solving skills
• Excellent verbal, written, and telephonic communication skills
• Demonstrated motivational interviewing skills and ability to establish rapport and trust telephonically
• Strong attention to detail with exceptional documentation skills
• Commitment to compliance, regulatory requirements, and quality standards
• Highly organized and self-motivated with the ability to work independently with minimal supervision
• Strong time management and multitasking abilities
• Proficiency with computers and technology platforms used for case management and documentation
• Ability to interface effectively with members, providers, and internal stakeholders
• Ability to travel up to 50% of the time within 60 miles one way
• Must reside in Louisiana
• Ability to work a variable schedule, including two evenings per week until 9:00 PM local time
• Ability to meet established performance and productivity metrics
• Required: Bachelor's Degree in Healthcare, Human Services, Social Work, Psychology, Sociology, Public Health, or a related field
• Preferred: Medicaid experience; waiver program experience; Managed Care Organization (MCO) experience; Certified Case Manager (CCM) certification; Master's degree in a healthcare, social services, or related field; crisis intervention experience and skills; utilization review experience; case management and discharge planning experience; experience with QuickBase or similar case management platforms; proficiency with Microsoft Teams, Outlook, Word, Excel, and SharePoint; previous experience coordinating care for complex populations
Benefits:
• CVS Health bonus, commission or short-term incentive program in addition to base pay
• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting physical, emotional, and financial well-being, based on eligibility