CrawlJobs Logo

Case Management Coordinator - Transition of Care Team

https://www.cvshealth.com/ Logo

CVS Health

Location Icon

Location:
United States , Work at Home

Category Icon
Category:
-

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

21.10 - 36.78 USD / Hour
Save Job
Save Icon
Apply Position

Job Description:

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.

Job Responsibility:

  • Utilizes critical thinking and judgment to collaborate and inform the case management process
  • Facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources
  • 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 knowledgeably 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

Requirements:

  • 2+ years experience in behavioral health or social services
  • Ability to work 8:00 AM - 5:00 PM in assigned market time zone
  • 2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook)
  • Dedicated workspace free of interruptions
  • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted
  • Bachelor's Degree or non-licensed master level clinician with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) or equivalent experience (REQUIRED)

Nice to have:

  • Case management and discharge planning experience
  • Managed care experience
What we offer:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
March 23, 2026

Expiration:
April 12, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Icon
CVS Health - All Job Offers
Job Link Share:
Copy Link Icon
Facebook Icon Twitter Icon LinkedIn Icon

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Case Management Coordinator - Transition of Care Team

Embedded Transitional Care Manager RN

Oak Street Health takes a team-based approach to providing outstanding patient c...
Location
Location
United States , Rockford
Salary
Salary:
66575.00 - 142576.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • An active RN license within the state of practice in good standing
  • Willingness to obtain cross-state licensure, as needed
  • Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
  • 2+ years’ experience in transitional nursing, discharge planning, nursing case management, or home health
  • Experience in utilization management preferred
  • Knowledge of Medicare/Medicaid and NCQA regulatory transitions of care criteria
  • Exceptional communication skills and customer service orientation
  • Innovative and independent problem solving skills
  • Ability to monitor and evaluate opportunities for cost-effective care options with high-quality outcomes
  • Spanish-speaking preferred but not required
Job Responsibility
Job Responsibility
  • Manage patients through transitions of care
  • Advocate for the patient throughout the care continuum
  • Identify opportunities for improved program workflows
  • Maintain real-time and accurate records of patient status
  • Adhere to CMS, state specific and NCQA compliance criteria
  • Evaluate patient status post-ED visit or observation stay
  • Triage to determine appropriate follow up care
  • Engage directly with inpatient physicians, case managers, medical directors, and hospitalists
  • Coordinate with the Utilization Management team
  • Conduct structured clinical assessment to identify post-discharge needs
What we offer
What we offer
  • Paid vacation, sick time, and investment/retirement 401K match options
  • Health insurance, vision, and dental benefits
  • Affordable medical plan options
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access
  • Fulltime
Read More
Arrow Right

Care Coordinator Specialist

CareGivers America - NEPA, a Modivcare Personal Care Service, is looking for a C...
Location
Location
United States , Lewistown
Salary
Salary:
20.00 - 25.00 USD / Hour
caregiversamerica.com Logo
CareGivers America
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High school diploma or equivalent
  • 3+ years of Customer Service experience required
  • 3+ years of Home Care experience preferred
  • Scheduling experience strongly preferred
  • HHAeXchange experience strongly preferred
Job Responsibility
Job Responsibility
  • Oversee and manage the care coordination process for a caseload of patients, ensuring continuity and quality of care
  • Monitor patient progress, evaluate outcomes, and modify care plans as necessary to achieve optimal health outcomes
  • Manage the intake process, including reviewing referrals, verifying insurance coverage, and obtaining necessary authorizations for services
  • Ensure timely and accurate completion of required documentation, including patient assessments, consent forms, and care plans
  • Collaborate with referral sources, healthcare providers, and internal teams to ensure smooth transitions and facilitate the start of care
  • Serve as a primary point of contact for patients, families, and healthcare professionals, providing ongoing communication and support throughout the care coordination process
  • Facilitate effective communication and information sharing among the care team, ensuring all members are informed of pertinent patient information and updates
  • Act as a resource and mentor to Care Coordinator Associates, providing guidance and support in complex care coordination cases
  • Advocate for patients and their families to ensure their needs, preferences, and rights are respected and met throughout the care process
  • Monitor and evaluate the quality-of-care coordination services provided, ensuring adherence to regulatory standards and best practices
What we offer
What we offer
  • Medical, Dental & Vision Insurance
  • 401(k) with a 6% match
  • Paid Time Off
  • 10 Paid Holidays
  • Employee Assistance Program
  • Employee Discounts (retail, hotel, food, restaurants, car rental, and much more!)
  • Voluntary Term Life and AD&D Insurance
  • Legal Services Insurance
  • Short-Term and Long-Term Disability
  • Accident, Critical Illness & Hospital Indemnity Insurance
  • Fulltime
Read More
Arrow Right

Licensed Vocational Nurse Care Coordinator - Population Health

Provides care under the direct supervision of the Population Health Director of ...
Location
Location
United States , Irving
Salary
Salary:
Not provided
christushealth.org Logo
CHRISTUS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • LVN License in state of employment or compact
Job Responsibility
Job Responsibility
  • Manages a case load of 10,000-15,000 patients with identified gaps in care in collaboration with the Health Care Team
  • Works in collaboration with the PCMH Team in the design, implementation and evaluation of the PMH model as applicable
  • Works proactively to coordinate preventative/follow-up care for all patients receiving care from participating providers
  • Reviews patient medical record to identify care gaps
  • Schedules needed preventative services using evidenced based Physician approved protocols and documents the encounter
  • Fosters a Team approach by working collaboratively with the member, family, PCP and other members of the healthcare team to ensure coordination of services
  • Assists Nurse Navigators’ in performing transition of care outreach to discharged patients to schedule return visit with the PCP per guidelines
  • Employs knowledge of evidenced based guidelines to effectively communicate the importance of recommended procedures and testing
  • Facilitates a collaborative approach with care team for identification of and closure of care gaps
  • Utilizes educational and behavioral change strategies to promote patient collaboration with the care team
  • Fulltime
Read More
Arrow Right

Director, RN Case Management

The Director, RN Case Management provides strategic and operational leadership f...
Location
Location
United States , Denver, Colorado
Salary
Salary:
115700.00 - 150500.00 USD / Year
innovage.com Logo
InnovAge
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in Nursing (BSN)
  • Current state-issued Registered Nurse (RN) license
  • 5+ years of experience in acute care coordination, case management, or discharge planning
  • 2+ years of leadership or supervisory experience in a clinical setting
  • Demonstrated success in performance management, operational execution, and cross-functional collaboration
  • Experience in quality improvement, compliance adherence, or care coordination oversight
Job Responsibility
Job Responsibility
  • Leads, develops, and supports RN Case Managers, including recruitment, onboarding, coaching, and performance management
  • Establishes division-wide workflows, standards, and best practices for acute and post-acute care coordination
  • Partners with the VP of Nursing Operations and clinical leadership to implement staffing strategies, workload balancing, and coverage expectations for case management services
  • Oversees daily operational execution of case management functions, ensuring timely coordination, documentation, and communication across care teams
  • Ensures RNs receive training and ongoing development to maintain clinical competency in transitional care and utilization management
  • Oversees the experience of participants during hospitalization and post-acute stays, ensuring high-quality transitions and strong communication
  • Responds to escalated participant concerns in coordination with Center Directors, providers, and Quality teams
  • Ensures RN Case Managers collaborate effectively with participants, families, caregivers, and IDT members to support person-centered care plans
  • Monitors service KPIs and drives improvements in communication, responsiveness, and participant satisfaction during transitional care periods
  • Ensures division performance aligns with quality metrics related to readmissions, skilled days, length of stay, and transition-of-care outcomes
What we offer
What we offer
  • medical/dental/vision insurance
  • short and long-term disability
  • life insurance and AD&D
  • supplemental life insurance
  • flexible spending accounts
  • 401(k) savings
  • paid time off
  • company-paid holidays
  • Fulltime
Read More
Arrow Right

Case Manager TMC Rincon

Works with physicians and multidisciplinary team members to develop a plan of ca...
Location
Location
United States , Tucson
Salary
Salary:
Not provided
tmcaz.com Logo
Tucson Medical Center
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree in nursing or associate degree in nursing
  • Two (2) years of nursing or case management experience
  • For NICU – Three (3) years of NICU nursing experience
  • Current RN licensure permitting work in state of Arizona
  • Basic life support (BLS) required
  • Some departments may also require current CPR instructor certification, Neonatal Resuscitation Provider (NRP) certification
  • Knowledge of direct patient care and critical care procedures and techniques, tools, and responses required to ensure optimal patient care
  • Skill in evaluating cases and determining appropriate care and status
  • Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations
  • Ability to write reports, business correspondence and collaborate with case management leadership
Job Responsibility
Job Responsibility
  • Works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge
  • Ensures patient is progressing toward desired outcomes by continuously monitoring patient care through assessment and/or evaluation
  • Assesses and responds to patient/family/care giver needs by coordinating efforts of other treatment team members
  • Identifies and resolves barriers that hinder effective patient care
  • Improves quality and completeness of documentation
  • Collaborates and communicates with multidisciplinary teams in all phases of discharge planning process
  • Assesses, creates, implements evaluates, and modifies timely discharge plans
  • Assesses, intervenes, and acts as a resource in medical-legal situations for patients and families
  • Enters nursing orders for their assigned patient caseload related to discharge planning and transitional care needs
  • Assists patients and families in making difficult decisions, while honoring their preferences and values
Read More
Arrow Right

Complex Inpatient Medical Social Worker

Provides care management/social work services to Complex patients, families, and...
Location
Location
United States
Salary
Salary:
33.05 - 49.60 USD / Hour
advocatehealth.com Logo
Advocate Health Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Master’s Degree in Social Work
  • LSW license issued by the State in which the team member practices (WI & IL Divisions)
  • Accredited Case Manger SW (ACM-SW) certification issued by the American Case Management Association (ACM) needs to be obtained within 2 years, or Certified Case Manager (CCM) issued by the Commission for Case Manager Certification (CCMC) needs to be obtained within 2 years, or Certified Social Worker in Health Care (C-SWHC) issued by National Association of Social Workers to be obtained within 2 years
  • 3 years of hospital care management experience
  • Ability to prioritize and organize work
  • Effective communication skills
  • Utilization of critical thinking and timely decision making
  • Ability to navigate the electronic health record
  • Basic utilization of MS Office products
  • Knowledge of Medicare A and B guidelines
Job Responsibility
Job Responsibility
  • Provides care management/social work services to Complex patients, families, and individuals including perming thorough patient psychosocial assessments, screening, determination of needs evaluation, appropriate interventions and follow up, and discharge planning
  • Implements targeted interventions and patient-family centered care plans to achieve optimal health outcomes
  • Collaborates and negotiates effectively with socially complex patients, family and the clinical team while striving to achieve patient and organizational goals regarding care needs, choices, and satisfaction during discharge planning and care transitions
  • Provide continuity of care and discharge planning services for socially complex patients compliant with regulatory standards
  • Provides advanced care management guidance and mentorship to frontline care management team members fostering a culture of excellence and continuous improvement
  • Initiates internal and external referrals to ensure timely progression of care and transitions for socially complex patients
  • Documents discharge planning interventions and utilization review activity according to department and organization standards in a timely manner
  • Advocates for patients and their families to ensure their voices are heard and their needs are met within the healthcare system while optimizing the utilization of hospital resources ensuring cost-effective care delivery and adherence to regulatory guidelines
  • Communicates effectively with the healthcare team regarding socially complex patients
  • Serves as a leader of the multidisciplinary rounds and work closely with clinical team members, hospital departments and ancillary services to identify and resolve barriers to discharge, expedite care delivery to avoid delays in timely service provision, and implement and report on care coordination and discharge planning
What we offer
What we offer
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program
  • Fulltime
Read More
Arrow Right

Director Care Coordination

As our Director of Care Coordination, you will be responsible for leading, facil...
Location
Location
United States , Gilbert
Salary
Salary:
57.37 - 85.33 USD / Hour
americannursingcare.com Logo
American Nursing Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum Bachelors of Nursing required or Master's in Social Work
  • Seven years administrative and health care system experience
  • Seven years of clinical and care management experience
  • Five years of leadership experience
  • Registered Nurse: AZ
  • Certified Case Manager upon hire
  • Accredited Case Manager upon hire
Job Responsibility
Job Responsibility
  • Lead, facilitate, and implement strategies to optimize patient care coordination and outcomes
  • Oversee the comprehensive care coordination functions, ensuring seamless transitions, efficient resource utilization, and patient-centered approaches
  • Work closely with interdisciplinary teams, physicians, and leadership to enhance clinical effectiveness, patient satisfaction, and alignment with system goals
  • Drive continuous improvement initiatives, analyze performance metrics, and ensure adherence to best practices and regulatory standards
  • Oversee the daily operations of the Care Coordination program, ensuring accountability, effectiveness, efficiency, and compliance with regulatory and accreditation agencies
  • Accept multiple management tasks to handle financial, operations, managed care & staffing issues within the Care Management departments
  • Serve as clinical advisor to care management across the continuum of care for all programs
  • Analyze data and develop strategies and action plans to address opportunities for improvement
  • Develop department and division strategies to ensure efficient operations and goal achievement
  • Maintain relationships with medical staff members, CNO, nurse VPs, Directors/managers, department managers and technical Directors
What we offer
What we offer
  • Medical
  • Prescription drug
  • Dental
  • Vision plans
  • Life insurance
  • Paid time off (minimum of 14 days including holidays annually for full-time benefit eligible team members)
  • Tuition reimbursement
  • Retirement plan benefit(s) including 401(k), 403(b), and other defined benefits offerings
  • Fulltime
Read More
Arrow Right
New

Registered Nurse - Case Manager

We’re building a world of health around every individual — shaping a more connec...
Location
Location
United States , Roseville
Salary
Salary:
60522.00 - 129615.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
June 30, 2026
Flip Icon
Requirements
Requirements
  • Current RN license in assigned state is required
  • Bachelor degree in nursing preferred
  • Minimum of 6-8 years nursing experience
  • Certified Case Manager (CCM) required, or willingness to obtain within 12 months of hire, unless candidate has 2-3 years of relevant care/case management experience
  • 2+ years experience in transitional nursing, emergency room nursing, care coordination, discharge planning, or home health is strongly preferred
  • Demonstrated skill in motivational interviewing, patient activation, time management, and navigating community and social resources
  • A flexible and positive attitude
  • Comfort with ambiguity and change
  • High emotional intelligence as evidenced by ability to evaluate/perceive a situation from multiple lenses and understand various perspectives in coming to problem resolution
  • Access to reliable transportation and ability to travel throughout the communities OSH serves
Job Responsibility
Job Responsibility
  • Manages an assigned caseload of complex patients in a value-based care environment, with a focus on driving reduced admissions, readmissions, and medical utilization
  • Accountable for panel metric performance in admission prevention, readmission prevention, and transitions of care metrics
  • Owns overall care coordination for assigned patients, functioning as the primary point of contact and ensuring alignment, accountability, and follow-through across the care team
  • Manage transitions of care episodes for patients on their panel, including timely completion of structured clinical assessments to identify post-discharge needs, medication reconciliation on behalf of the PCP, and addressal of identified needs directly or via collaboration with other team members
  • Collaborates patient’s PCP, family/caregiver, Social Worker, Behavioral Health Specialists, and other care team members, as needed to evaluate the individual's needs, goals, and plan of action and ensure care plan progression
  • Ensure timely documentation of key clinical assessments after admissions, while balancing in-center care team planning meetings
  • Lead in-person interdisciplinary care planning meetings to ensure effective care coordination and management between providers visits
  • Perform timely nursing assessments and provide patient education for chronic condition management and transitions of care
  • Educate patients and families, empowering them in their care, and advocating for their needs
  • Document visits in electronic health record according to internal standards
What we offer
What we offer
  • Paid vacation, sick time, and investment/retirement 401K match options
  • Health insurance, vision, and dental benefits
  • Opportunities for leadership development and continuing education stipends
  • New centers and flexible work environments
  • Opportunities for high levels of responsibility and rapid advancement
  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
  • Fulltime
Read More
Arrow Right
Jobs by Category
Art and Entertainment Jobs Banking Jobs Call Center Jobs Construction Jobs Consulting Jobs Customer Service Jobs Education Jobs Energy Jobs Finance Jobs Gastronomy Jobs Health and Beauty Jobs Hospitality and Tourism Jobs Human Resources Jobs Insurance Jobs IT - Administration Jobs IT - Software Development Jobs Legal Jobs Logistics Jobs Manufacturing Jobs Marketing, Digital Marketing, SEO, SEM Jobs Media Jobs Nursing Jobs Office Administration Jobs Pharmacy Jobs Physical Work Jobs Public Relations Jobs Public Sector Jobs Purchasing Jobs Quality Control Jobs Real Estate Jobs Research and Development Jobs Sales Jobs
Job Positions Jobs by Country
United States Jobs United Kingdom Jobs India Jobs Canada Jobs Australia Jobs Germany Jobs Ireland Jobs Poland Jobs
Company
Blog About Us Contact
Follow Us
Facebook
X (Twitter)
LinkedIn
Instagram
CrawlJobs Group
ITFlashcards AllDevBlogs
© 2026 CrawlJobs Ltd. All Rights Reserved
Terms & Conditions Privacy Policy