Job Description

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 Eastern Mountain Region (Breathitt, Floyd, Johnson, Knott, Lee, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike ,Wolfe). Qualified candidates may reside in or
adjacent to the assigned region.
Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm EST, is required. We are serving the
needs of children and families that may require working
after school, after work, etc.
Evaluation of Members:
- Through the use of care management assessments and
information/data review, recommends an approach to
resolving care needs maintaining optimal health and well-being by evaluating member\'s benefit plan and available
internal and external programs/services.
- Identifies high risk factors and service needs that may
impact member outcomes and implements early and
proactive support interventions.
- Coordinates and implements Wellness care plan activities
and monitors member care needs.
Enhancement of Medical Appropriateness and Quality of
Care:
- Using holistic approach consults with case managers,
supervisors, Medical Directors and/or other health
programs to overcome barriers to meeting goals and
objectives\xcd\xbe presents cases at case conferences to obtain
multidisciplinary review in order to achieve optimal
outcomes.
- Identifies and escalates quality of care issues through
established channels.
- Utilizes negotiation skills to secure appropriate options
and services necessary to meet the member\'s benefits
and/or healthcare needs.
- Utilizes 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.
- Helps member actively and knowledgably participate with
their provider in healthcare decision-making.
Monitoring, Evaluation and Documentation of Care:
- Utilizes case management and quality management
processes in compliance with regulatory and accreditation
guidelines and company policies and procedures.

Pay Range
The typical pay range for this role is:
Minimum: 19.50
Maximum: 40.10

This 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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company\'s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit

Required Qualifications
-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.
-Willing and able to travel 80-90% of their time to meet
members face to face in their assigned region.
-Candidate must reside in or adjacent to Breathitt, Floyd, Johnson, Knott, Lee, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike ,Wolfe counties in KY.

Preferred Qualifications
-Case management and discharge planning experience
preferred.
- Managed Care experience preferred.
- 6+ months Knowledge of growth and appropriate
developmental milestones strongly preferred.

Education
Minimum of a Bachelor\'s degree or a non-licensed master
level clinician is required with either degree being in
behavioral health or human services field

Business Overview
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\xe2\x84\xa2 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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