Case Management Coordinator – Transition of Care Team

September 17, 2026

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Job Description:

Evaluate referred members' needs and eligibility using care management tools and data review
Recommend case-resolution approaches and evaluate benefit plans and internal/external programs and services
Identify high-risk factors and service needs affecting member outcomes and care planning
Refer members to clinical case management or crisis intervention when appropriate
Coordinate, implement, and monitor assigned 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 through established channels
Negotiate appropriate options and services for members' benefits and healthcare needs
Use motivational interviewing 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 decisions with providers
Monitor, evaluate, and document care in compliance with regulatory, accreditation, and company requirements

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 preferred, or equivalent experience (REQUIRED)
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 virtual work location compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where the candidate currently lives
Microsoft Office 365 applications or similar Google Workspace experience
Ability to navigate multiple monitors and applications
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Ability to log in to secure systems such as VPN and EHR portals
Ability to maintain strong passwords and recognize suspicious emails or links
Ability to troubleshoot common technical issues independently

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, including keyboard, monitor, computer, and headset

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