Case Management Coordinator Telephonic & Community
CVS Health · Slaton, TX
Job description
Case Management Coordinator We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Program Overview: Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Position Summary/Mission: The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, The Case Management Coordinator facilitates appropriate healthcare outcomes for members by aiding with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. Key Responsibilities • Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs 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 care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. • Coordinates and implements assigned care plan activities and monitors care plan progress. • 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; 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. • Remote Work Expectations • Candidates must have a dedicated workspace free of interruptions • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. • Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician's office to provide ongoing case management services. • Colleague may be required to travel up to 25-50% of the time based on member/customer-specific needs. • Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise Required Qualifications • Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (nursing, psychology, social work, marriage and family therapy, counseling). • Must have computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Preferred Qualifications • Case management and discharge planning experience preferred • 2 years' experience in behavioral health, social services or appropriate related field equivalent to program focus • Managed Care experience preferred • Effective communication, telephonic and organization skills • Excellent analytical and problem-solving skills • Ability to work independently • Ability to effectively participate in a multi-disciplinary team including internal and external participants. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10 - $44.99 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.
More jobs in Slaton, TX
Dedicated CDL-A Truck Drivers CDL-A Dedicated runs offer high earnings, weekly home time, unique benefits, and more! It's an exciting time for CDL-A truck drivers to join USA Truck's Dedicated division because we offer high earning potential and weekly home time plus unique benefits when you join the USA Truck team. Learn more and apply today! Why choose USA Truck CDL-A dedicated truck driver jobs? • Earn up to $114,000 per year • Earn up to $2,190 per week • 1st year earnings $80,000 - $90,000 average • Dedicated account; weekly home time • 5.5-day work schedule Benefits • Paid time off (PTO) • Paid orientation • 7 paid holiday opportunities annually • Comprehensive healthcare coverage including Medical, Dental, and Vision • Company-paid Life and AD&D insurance • Access to a wide range of voluntary benefits • CDL Defender, Family Defender, and Identity Defender coverage options • 401(k) retirement plan • HSA and FSA benefit options • Rider and pet policy • Parking reimbursement program Bonus Opportunities • Long Haul Tenure Reward • Quarterly bonus - earn an additional $0.05 CPM every quarter! • Earn up to $3,000 in driver referral bonuses for qualified referrals Equipment & Technology • Late-model trucks equipped with 1500-1800 watt inverters and 100% automatic transmissions • Advanced in-cab technology including electronic logging and GPS navigation systems CDL-A Dedicated Truck Driver Job Requirements: • Must be at least 21 years of age • 6+ months CDL A driving experience required • No DUI, DWI, or moving violations involving drugs or alcohol in the last 3 years • Stable work history • Valid CDL-A and Medical Card A more positive driver experience starts at USA Truck. Fill out our short form today! Call 844-579-0850 or Apply Online!
$83k/yr
Truck Driver Company - 1-5mo EXP Required - OTR - Dry Van - $1.2k - $1.73k per week - U.S. Xpress - OTR
U.S. Xpress - OTR · Slaton, TX
Solo OTR CDL-A Truck Drivers: $7,500 Sign On Bonus!. Solo OTR Drivers: 2,000+ Miles Per Week On Average $7,500 SIGN ON BONUS Guaranteed Weekly Minimum Pay of $1,200 Available** Top 20% of our OTR Drivers earn $1,725+ Weekly Earn $83,200 per year on average. Team Drivers: $10,000 Sign On Bonus/split...
$85k–$110k/yr
$85 - $110K /Yr! Hiring CDL-A Truck Drivers - Quick Apply!
Hiring Drivers Now · Slaton, TX
Now Hiring CDL-A Truck Drivers! Apply today and within 24 hours you'll receive multiple job offers. Earn $.60 - $.80+ CPM and up per year based on position. Simply select the driving job that offers you what is most important. Higher pay, increased benefits or more home-time: You choose. Avg. Company Driver Job Offers Salary: $85,000-$110,000+ Avg. Owner Operator Job Offers Salary: $200,000-$325,000+ Apply now to receive your job offers!
Customer Service Rep Associate
Corewell Health · Slaton, TX
Job Summary Inbound call center to assist and educate members, employer groups, providers, colleagues, and/or agents of health plan benefits with accessing services, facilitating and resolving problems, understanding claims, billing and coding, along with other questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions, online chat, email, etc. Essential Functions • Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations. • Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status. • Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in members and agents if assigned by leadership. • Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements. • Assists members with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed. • Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments. • Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines. • Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule. • Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis. • Performs other duties as assigned. Qualifications Required • High School Diploma or equivalent • 1 years of relevant experience customer-facing service on phone or face to face; customer service, high volume call center, medical billing, insurance environment relevant to benefits, provider contracting, claims processing, and/or managed health care Preferred • Associate's degree About Corewell Health As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence. How Corewell Health cares for you • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here. • On-demand pay program powered by Payactiv • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! • Optional identity theft protection, home and auto insurance • Traditional and Roth retirement options with service contribution and match savings • Eligibility for benefits is determined by employment type and status Primary Location SITE - 1700 Magnavox Way Suite 201 - Fort Wayne Department Name Physicians Health Plan of Northern Indiana Admin - PH Managed Benefits Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work 8 a.m. to 5 p.m. Days Worked Monday to Friday Weekend Frequency N/A CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling 616.486.7447.