Demonstrates expertise in case management, care coordination, and behavioral health, with a strong focus on member engagement and quality care outcomes. Proficient in implementing care plans and navigating healthcare systems while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Case Management ExperienceBehavioral Health ExpertiseCare Coordination SkillsMotivational InterviewingManaged Care Knowledge

About the role

Key responsibilities & impact

Conduct routine care coordination, support, and education using care management resources
Facilitate appropriate healthcare outcomes for waiver/LTSS members
Implement projects, programs, and processes for Case Management
Manage a full caseload of waiver members
Travel 50–75% of the time to meet members face to face
Conduct in-person quarterly member visits
Evaluate referred members’ needs, eligibility, benefit plans, and available programs/services
Identify high-risk factors and service needs, with referrals to clinical case management or crisis intervention as appropriate
Coordinate, implement, and monitor care plan activities
Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
Present cases at multidisciplinary case conferences
Identify and escalate quality-of-care issues
Negotiate appropriate options and services for members
Use influencing and motivational interviewing skills to engage members and promote lifestyle/behavior changes
Provide coaching, information, and support for independent medical and healthy lifestyle choices
Support members in participating in healthcare decision-making with providers
Apply case management and quality management processes in compliance with regulatory, accreditation, and company guidelines

Requirements

What you’ll need

Must reside in the state of Illinois in Fayette County or Surrounding Areas
Willing and able to travel up to 75% of their time to meet with members face to face
Reliable Transportation required, eligible for mileage reimbursement as per company policy
Minimum 2 years of experience in Behavioral Health, Social Services or Human Services field
Minimum of two (2) years of case management experience
Valid Driver’s license, preferably out of IL
Bachelor’s degree or a non-licensed individual with a master’s degree, with either degree being in a Behavioral Health or Human Services field
Case management and discharge planning experience preferred
Managed Care experience preferred
Microsoft Office experience preferred

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementCare CoordinationDischarge PlanningBehavioral HealthQuality Management ProcessesHealthcare Outcomes EvaluationCrisis InterventionMember Needs AssessmentRegulatory ComplianceProject Implementation

Soft Skills

Influencing SkillsMotivational SkillsCoaching SkillsCommunication SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeCare Management Resources

Certifications & Qualifications

Valid Driver’s License

Industry Keywords

Human ServicesSocial ServicesManaged CareLTSSHealthcare Decision-Making