This is a telework position that requires regional in-state travel 5-10% of the time. Travel is with a personal vehicle.

Candidate must reside within Cumberland region ( Adair, Casey, Cumberland, Clinton, Green, Taylor, Adair, Russell, Pulaski, Wayne, McCreary, Rockcastle, Laurel, Whitley, Bell, Knox, Clay, Jackson, and Harlan Counties).

The Population Health/Wellness Care Management Coordinator (CMC) utilizes

• critical thinking and professional judgment to support the care 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.
• 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: o Using holistic approach consults with care managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cares at care conferences to obtain multidisciplinary review in order to achieve optimal outcomes.

o 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.
o 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.
o Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
o Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
o Helps member actively and knowledgeably participate with their provider in healthcare decision-making.

• Monitoring, Evaluation and Documentation of Care: o Utilizes care 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

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• 2 years’ experience in behavioral health, social services, or human services field.
• 1 year experience with MS Office Suite applications, including Word and Excel.
• Willing and able to travel 5-10% of their time for regional in state travel.
• Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, is required, as we are serving the needs of children and families that may require working after school, after work, etc.

Preferred Qualifications

• Knowledge of growth and developmental milestones.
• Care management experience
• Discharge planning experience
• Managed Care experience
• 6 months of Experience and detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, or evidence-based practices applicable to the Kentucky SKY populations.

Education
Minimum of a Bachelor's degree or a non-licensed master level clinician is required with either degree being in behavioral health or a relevant human services field of study (social work, psychology, marriage and family therapy, counseling) required.

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™ 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.