Case Management Coordinator – Transition of Care Team

September 14, 2026

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Job Description:

Evaluate referred members' needs and eligibility using care management tools and data review
Recommend approaches to case resolution and meeting members' needs
Identify high-risk factors and service needs affecting outcomes and care planning
Refer members to clinical case management or crisis intervention when appropriate
Coordinate and implement assigned care plan activities
Monitor care plan progress
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' benefit and healthcare needs
Use influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes
Provide coaching, information, and support for independent medical and healthy lifestyle choices
Help members participate knowledgeably in healthcare decision-making with providers
Apply case management and quality management processes in compliance with regulatory, accreditation, and company guidelines
Schedule appointments and assist members with accessing benefits, education, and services

Requirements:

2+ years of experience in behavioral health or social services
Ability to work 8:00 AM–5:00 PM in the assigned market time zone
2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook)
Dedicated workspace free of interruptions
Separate care arrangements for dependents during work hours
Case management and discharge planning experience preferred
Managed care experience preferred
Bachelor's Degree or non-licensed master level clinician degree in behavioral health or human services, or equivalent experience (REQUIRED)
Ability to obtain a direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
WiFi and satellite internet are not permitted
Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where currently residing
Ability to set up and use multiple monitors and navigate multiple applications
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace tools
Ability to log in to secure systems such as VPN and EHR portals
Ability to manage strong passwords and recognize suspicious emails or links
Ability to resolve common technical issues independently
Openness to learning new skills as the workplace environment evolves

Benefits:

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
Company-provided equipment (keyboard, monitor, computer, headset, etc.)

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