Case Management Coordinator

CVS Health Careers

. Coordinate, document, and communicate all aspects of the utilization/benefit management program .

Posted 11/10/2026full-timeRemote • Arizona • United StatesJuniorMid-Level💰 $21 - $41 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management processes, including care coordination, comprehensive evaluations, and compliance with regulatory standards. Proficient in applying evidence-based care and motivational interviewing to support member engagement and decision-making.

Highest-signal resume keywords

Case Management ExperienceKnowledge of Serious Mental Illness (SMI)Experience with Elderly PopulationBilingual English/SpanishBachelor’s Degree in Social Work, Psychology, or Counseling

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care CoordinationComprehensive EvaluationsEvidence-Based CareMotivational InterviewingMedical Necessity CriteriaCase-Resolution ApproachesCare-Plan ImplementationQuality-of-Care Issue IdentificationTime ManagementOrganizational Skills

Soft Skills

CollaborationCommunicationCoachingEmpowermentNegotiation

Tools & Technologies

Microsoft Office SuiteOutlookWord

Certifications & Qualifications

Licensed RN in Arizona

Industry Keywords

Utilization ManagementBenefit ManagementHigh-Risk FactorsHealthcare Decision-MakingRegulatory Compliance

About the role

Key responsibilities & impact

Coordinate, document, and communicate all aspects of the utilization/benefit management program
Apply critical thinking, clinically appropriate treatment knowledge, evidence-based care, and medical necessity criteria
Provide care coordination, support, and education using care management tools and resources
Conduct comprehensive evaluations of referred members’ needs and eligibility
Recommend case-resolution approaches by evaluating benefit plans and internal and external programs/services
Identify high-risk factors and service needs and make appropriate referrals
Coordinate and implement assigned care-plan activities and monitor progress
Present cases at case conferences for multidisciplinary review
Identify and escalate quality-of-care issues
Negotiate appropriate options and services for members’ benefit and healthcare needs
Use motivational interviewing to promote member engagement and lifestyle/behavior changes
Coach and empower members to make independent medical and healthy-lifestyle choices
Support members in participating knowledgeably in healthcare decision-making
Apply case-management processes in compliance with regulatory, accreditation, and company requirements

Requirements

What you’ll need

2+ years of experience in case management
Experience working with people designated as having a serious mental illness (SMI)
Experience working with elderly people
Experience working with members with a physical disability
Must reside in Maricopa County, Arizona
Willingness to travel up to 50% of the time within Maricopa County, Arizona
Bachelor’s degree in Social Work, Psychology, Special Education, or Counseling, or valid Arizona licensed RN (Registered Nurse)
Strong organizational and time management skills
Ability to collaborate with internal and external partners
Proficiency in Microsoft Office Suite, including Outlook and Word
Previous experience collaborating with medical professionals
Bilingual English/Spanish preferred

Benefits

Comp & perks

$5,000 sign-on bonus
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program (in addition to base pay)