care management coordinator

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;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 &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><h2 class="jobSectionHeader"><b>
Program Summary</b></h2><p>
Join our Aetna care management team as we lead the way in providing exceptional care to dual eligible populations! You will have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid. As a member of the care team, you will collaborate with members, the internal care team, healthcare providers, and community organizations to meet the complex healthcare and social needs of our members Be part of this exciting opportunity as we expand our DSNP services to transform lives in new markets across the country.</p><p></p><p><b>
Position Summary/Mission</b></p><p>
As a vital member of our Special Needs Plan (SNP) care team, the Care Coordinator (CC) is responsible for coordinating care for our members through close collaboration with the Care Manager, Social Worker, and other interdisciplinary team members. This role involves evaluating member needs through the annual Health Risk Survey, addressing social determinants of health (SDoH), coordinating care across the continuum, and closing gaps in preventive and health maintenance care.</p><p></p><p><b>
Key Responsibilities</b></p><ul><li><p><b>
Member Evaluation:</b> Conduct the annual Health Risk Survey to support needs identification for the member&rsquo;s Individual Plan of Care.</p></li><li><p><b>
Risk Escalation:</b> Inform the assigned care manager of newly identified health/safety risks or service needs</p></li><li><p><b>
Care Coordination:</b> Complete care coordination activities delegated by the care manager within an established timeframe.</p></li><li><p><b>
Quality Issue Escalation:</b> inform the assigned care manager and/or associate manager of any identified quality of care issues.</p></li><li><p><b>
Advocacy: </b>Passionately support the member&rsquo;s care coordination needs and drive solutions to address those needs.</p></li><li><p><b>
Member Engagement: </b>Use problem-solving skills to find alternative contact information for members who are unreachable by care management. Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health.</p></li><li><p><b>
Monitoring and Documentation: </b>Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies.</p></li></ul><p></p><p><b>
Essential Competencies and Functions</b></p><ul><li><p>
Meet performance and productivity metrics, including call volume, successful member engagement, and compliance with state/federal regulatory requirements.</p></li><li><p>
Conduct oneself with integrity, professionalism, and self-direction.</p></li><li><p>
Demonstrate a willingness to learn about care management within Medicare and Medicaid managed care.</p></li><li><p>
Familiarity with community resources and services.</p></li><li><p>
Navigate various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.</p></li><li><p>
Maintain strong collaborative and professional relationships with members and colleagues.</p></li><li><p>
Communicate effectively, both verbally and in writing.</p></li><li><p>
Exhibit excellent customer service and engagement skills.</p></li></ul><p></p><p><b>
Work Expectations</b></p><ul><li><p>
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position</p></li><li><p>
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted</p></li></ul><p></p><p><b>
Required Qualifications</b></p><ul><li><p>
2+ years in behavioral health, social services, or a related field relevant to the program focus</p></li><li><p>
Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) and capable of utilizing these tools effectively in the Care Management Coordinator role</p></li><li><p>
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position</p></li><li><p>
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted</p></li></ul><p></p><p><b>
Preferred Qualifications</b></p><ul><li><p>
Case management and discharge planning experience</p></li><li><p>
Managed care experience</p></li></ul><p></p><p><b>
Education</b></p><ul><li><p>
High School Diploma with equivalent experience (REQUIRED)</p></li><li><p>
Associate&rsquo;s or Bachelor&rsquo;s Degree or non-licensed master&rsquo;s level clinician in behavioral health or human services (psychology, social work, marriage and family therapy, counseling) or equivalent experience (PREFERRED)</p></li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$21.10 - $40.90<p></p><p>
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.</p><p><br>
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.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> 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.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
We anticipate the application window for this opening will close on: 04/19/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Care Management Coordinator

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;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 &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><div><h2 class="jobSectionHeader"><b>
Program Summary</b></h2></div><div><div><div><div><div><div><div><div><div><p>
Join our Aetna care management team as we lead the way in providing exceptional care to dual eligible populations! You will have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid. As a member of the care team, you will collaborate with members, the internal care team, healthcare providers, and community organizations to meet the complex healthcare and social needs of our members Be part of this exciting opportunity as we expand our DSNP services to transform lives in new markets across the country.</p><p></p><p><b>
Position Summary/Mission</b></p><p>
As a vital member of our Special Needs Plan (SNP) care team, the Care Coordinator (CC) is responsible for coordinating care for our members through close collaboration with the Care Manager, Social Worker, and other interdisciplinary team members. This role involves evaluating member needs through the annual Health Risk Survey, addressing social determinants of health (SDoH), coordinating care across the continuum, and closing gaps in preventive and health maintenance care.</p><p></p><p><b>
Key Responsibilities</b></p><ul><li><p><b>
Member Evaluation:</b> Conduct the annual Health Risk Survey to support needs identification for the member&rsquo;s Individual Plan of Care.</p></li><li><p><b>
Risk Escalation:</b> Inform the assigned care manager of newly identified health/safety risks or service needs</p></li><li><p><b>
Care Coordination:</b> Complete care coordination activities delegated by the care manager within an established timeframe.</p></li><li><p><b>
Quality Issue Escalation:</b> inform the assigned care manager and/or associate manager of any identified quality of care issues.</p></li><li><p><b>
Advocacy: </b>Passionately support the member&rsquo;s care coordination needs and drive solutions to address those needs.</p></li><li><p><b>
Member Engagement: </b>Use problem-solving skills to find alternative contact information for members who are unreachable by care management. Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health.</p></li><li><p><b>
Monitoring and Documentation: </b>Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies.</p></li></ul><p></p><p><b>
Essential Competencies and Functions</b></p><ul><li><p>
Meet performance and productivity metrics, including call volume, successful member engagement, and compliance with state/federal regulatory requirements.</p></li><li><p>
Conduct oneself with integrity, professionalism, and self-direction.</p></li><li><p>
Demonstrate a willingness to learn about care management within Medicare and Medicaid managed care.</p></li><li><p>
Familiarity with community resources and services.</p></li><li><p>
Navigate various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.</p></li><li><p>
Maintain strong collaborative and professional relationships with members and colleagues.</p></li><li><p>
Communicate effectively, both verbally and in writing.</p></li><li><p>
Exhibit excellent customer service and engagement skills.</p></li></ul><p></p><p><b>
Work Expectations</b></p><ul><li><p>
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position</p></li><li><p>
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted</p></li></ul><p></p><p><b>
Required Qualifications</b></p><ul><li><p>
2+ years in behavioral health, social services, or a related field relevant to the program focus</p></li><li><p>
Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) and capable of utilizing these tools effectively in the Care Management Coordinator role</p></li><li><p>
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position</p></li><li><p>
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted</p></li></ul><p></p><p><b>
Preferred Qualifications</b></p><ul><li><p>
Case management and discharge planning experience</p></li><li><p>
Managed care experience</p></li></ul><p></p><p><b>
Education</b></p><ul><li><p>
High School Diploma with equivalent experience (REQUIRED)</p></li><li><p>
Associate&rsquo;s or Bachelor&rsquo;s Degree or non-licensed master&rsquo;s level clinician in behavioral health or human services (psychology, social work, marriage and family therapy, counseling) or equivalent experience (PREFERRED)</p></li></ul></div></div></div></div></div></div></div></div></div><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$21.10 - $40.90<p></p><p>
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.</p><p><br>
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.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> 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.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
We anticipate the application window for this opening will close on: 04/19/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

CoachCare

<p><b>Remote Care Management Coordinator ***Certified Medical Assistants (CMAs) ***</b><br/><i>Fully Remote Position</i><br/><i>No weekends or evenings</i></p><p><b>Overview</b><br/>The remote <i>Care Management Coordinator</i> is responsible for the daily <i><b>(very heavy patient call volume)</b></i> patient monitoring of medical data, alerts, and messages. Conduct outbound virtual audio/video check-ins with patients on a monthly basis or as needed. Triage clinical situations to determine whether the patient needs further intervention by their healthcare provider. We work with RPM, CCM, and other Care Management services.</p><p><b>Qualifications</b></p><ul><li>Current CMA or RMA certification - unrestricted with no adverse actions pending or taken by any State or Federal program</li><li>2+ years clinical experience - provide information on resume</li><li>Experience educating patients regarding acute and/or chronic conditions</li><li>Ability to communicate effectively with a diverse range of individuals to include patients and providers</li><li>Must have reliable internet service</li><li>Must have basic computer skills - We will provide an assessment</li><li><i><b>Ability to handle a very fast paced, heavy patient call volume environment</b></i></li><li>Goal oriented, independent</li><li>Enjoy direct communication with supervisors and team mates</li><li><b>Available to work day shift hours in your time zone based on client needs</b></li></ul><p><b>Responsibilities</b></p><ul><li>Work closely with assigned patients, practices, providers, and provider team members virtually</li><li>Daily alerts, messages, and data monitoring of individual patient activity</li><li>Escalate changes in patient health status as directed by provider</li><li>Build strong relationships with patients, providers, and provider teams</li><li>Document all actions and interactions in patient electronic chart</li><li>Perform outbound virtual visits with patients</li><li>Provide patient coaching / education as directed by providers</li></ul><p><b>Compensation</b></p><ul><li>Salary = $37,440/year ($18/hour) &amp; will eligible to receive an increase each year!</li></ul><p><b>Benefits:</b></p><ul><li>401(k) (after 1 year of employment)</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off (after 90 days of employment)</li><li>Vision insurance</li></ul><p>Job Type: Full-time</p><p>Pay: $37,440.00 per year</p><p>Experience:</p><ul><li>Patient monitoring: 2 years (Preferred)</li></ul><p>License/Certification:</p><ul><li>Certified Medical Assistant (Preferred)</li></ul><p>Work Location: Remote</p>

Remote Certified Medical Assistant

SynerGrx

<p><b>About SynerGrx</b></p><p>SynerGrx is a pharmacist-led chronic care management organization that integrates Clinical Pharmacists, Clinical Pharmacy Technicians, and Medical Assistants into primary care and specialty practices to improve patient outcomes. We partner directly with providers to deliver CCM, RPM, and preventive care services that enhance quality, drive medication adherence, and reduce avoidable healthcare costs. Our team is committed to elevating the standard of pharmacy-driven patient care, and we are looking for individuals who share that mission.</p><p><b>Position Summary: Care Coordinator (Chronic Care Management)</b></p><p>The Care Coordinator plays a key role in providing chronic care management services and supporting pharmacist-driven patient care. This position is ideal for tech-savvy, patient-centered individuals who excel at communication, organization, and clinical documentation. You will support comprehensive outreach activities, prepare care plan documentation, and collaborate with providers and pharmacists to ensure patients receive consistent, high-quality chronic care management services.</p><p><b>Key Responsibilities: </b></p><p><b>Chronic Care Management Patient Engagement &amp; Outreach</b></p><ul><li>Perform monthly outreach to enrolled CCM patients to review care needs, identify barriers, and support medication adherence.</li><li>Document clinical updates including symptoms, lifestyle factors, self-monitoring results, and social determinants of health.</li><li>Provide education to patients on chronic disease management under clinician direction.</li></ul><p><b>Documentation &amp; Care Coordination</b></p><ul><li>Maintain accurate patient profiles, care plans, vitals, medication histories, and care documentation in Apothedoc and partner EHR systems.</li><li>Prepare clinical documentation for pharmacist review, including pre-visit summaries and care plan updates.</li><li>Track and monitor interventions, referrals, and follow-up items to ensure continuity of care.</li></ul><p><b>Medication-Related Support</b></p><ul><li>Identify gaps in adherence, refill delays, and high-risk medication concerns; escalate to pharmacists when clinical review is required.</li><li>Assist with gathering information for prior authorizations, coverage determinations, and formulary alternatives.</li></ul><p><b>Operational Support</b></p><ul><li>Respond to patient calls, portal messages, and provider inquiries in a timely and professional manner.</li><li>Support workflow efficiency by organizing tasks, triaging patient concerns, and maintaining communication with clinic partners.</li><li>Assist with onboarding and supporting new team members and contribute to training initiatives.</li></ul><p><b>Professionalism &amp; Collaboration</b></p><ul><li>Demonstrate a professional appearance and demeanor during all patient, provider, and clinic interactions.</li><li>Maintain confidentiality, adhere to HIPAA requirements, and follow all SynerGrx protocols and safety policies.</li></ul><p><b>Minimum Qualifications:</b></p><ul><li>High school diploma or equivalent.</li><li>Active registration/certification as a <b>Certified Clinical Pharmacy Technician (PTCB or NHA)</b> <b>OR</b> a <b>Certified Medical Assistant (CMA, RMA, or NCMA)</b>.</li><li>At least 5 year of experience in community, retail, managed care, clinical pharmacy, or clinical medical office settings.</li><li>Proficient with Microsoft Office and ability to learn clinical and pharmacy software systems.</li><li>Must be eligible to work in the U.S. and not listed on the OIG/SAM exclusion lists.</li><li>Completion of required onboarding training (e.g., HIPAA, Fraud/Waste/Abuse).</li><li>Must maintain certification and registration throughout employment.</li><li>English language proficiency required; Spanish preferred but not required.</li></ul><p><b>Preferred Qualifications:</b></p><ul><li>Experience with electronic health records (EHRs).</li><li>Medication Therapy Management (MTM) Certification (for pharmacy technicians).</li></ul><p><b>Core Competencies:</b></p><ul><li>Strong problem-solving and analytical skills.</li><li>Excellent oral and written communication.</li><li>Commitment to customer service and patient care.</li><li>Ability to prioritize tasks and manage time effectively.</li><li>Team player with strong interpersonal skills.</li><li>High ethical standards, confidentiality, and professionalism.</li><li>Adaptability in fast-paced, patient-centered environments.</li><li>Ability to follow procedures and comply with safety standards.</li></ul><p><b>Physical &amp; Work Requirements:</b></p><ul><li>Moderate sitting, typing, and computer work.</li><li>Able to drive for work-related travel (as needed).</li><li>Able to work independently and adapt to changing priorities.</li></ul><p><b>Benefits:</b></p><ul><li>Paid Holidays &amp; PTO</li><li>Medical, Dental, and Vision Insurance</li><li>Short &amp; Long-Term Disability Insurance</li><li>Life Insurance</li><li>401(k) with <b>5% Match for 4% Contribution</b></li><li>Financial Education Resources</li></ul><p>Job Type: Full-time</p><p>Pay: $52,000.00 per year</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Disability insurance</li><li>Employee discount</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Opportunities for advancement</li><li>Paid time off</li><li>Prescription drug insurance</li><li>Professional development assistance</li><li>Retirement plan</li><li>Vision insurance</li></ul><p>License/Certification:</p><ul><li>Pharmacy Technician Certification (Preferred)</li><li>Certified Medical Assistant (Preferred)</li></ul><p>Work Location: Hybrid remote in Atlanta, GA 30341</p>

Care Coordinator

National Youth Advocate Program

<div><div><div><b>We are looking for a full-time Care Coordinator to join our NYAP Baltimore-Chicago, IL office!
</b></div></div><p></p><div><div><b>Salary: </b>$48,500/yr.
</div></div><p></p><div><div><b>Hours:</b> <b>40 hours a week Monday-Friday with varying start/end times depending on client and caseload needs.<br>
</b></div><br>
<br>
<br>
</div><div><div><b>Position Summary:</b></div></div><div><div>
The Care Coordinator works collaboratively with a multidisciplinary team in coordinating care for individuals served in the community to support independence.</div></div><p>
</p><div><div><b>Working At NYAP:</b></div></div><ul><li><div>
NYAP's commitment to doing what is <i>best</i> for children, youth and their families is a <b>core value</b> and one that we look for in our newest team members.</div></li><li><div>
Excellent<b> training and continuing education and development opportunities</b> offered on topics such as: PCIT, NMT, TF-CBT, BFST, CSAYC, TBRI, FFT and many, many more!</div></li><li><div><b>
Student Loan Repayment assistance</b>, up to $1,200 per year!</div></li><li><div>
Medical, Dental, and Vision insurance for you and your family!</div></li><li><div><b>
22 Days Off</b> Each Year!
</div></li><li><div><b>Plus 11</b> Paid Holidays Per Year!</div></li><li><div>
Competitive salaries and benefits including a 401(k)</div></li><li><div>
Tuition Assistance</div></li><li><div>
Work Anniversary Trips!</div></li><li><div>
Peace leave</div></li><li><div>
Parental leave</div></li><li><div>
Flexible schedule
</div></li><li><div>Mileage Reimbursement</div></li></ul><p>
</p><div><div><b>Responsibilities:</b></div></div><div><div>
The Care Coordinator will perform duties including, but not limited to:</div></div><ul><li><div>
Coordination of care with family, Primary Care Provider, and other community provider</div></li><li><div>
Assist clients in medical appointment coordination</div></li><li><div>
Coordinates with the NYAP Nurse and Psychiatrist virtual Telehealth appointments with client</div></li><li><div>
Assist client in Vocational and employment services.</div></li><li><div>
Assists client in medication refills and promotes medication compliance.
</div></li><li><div>Link clients to natural, social, community, and family supports.</div></li><li><div>
Works closely with all members of the treatment team to ensure client is receiving the recommended care on treatment plan.</div></li><li><div>
Actively and directly, engage with the client to meet service needs and goals/objectives of the treatment/service plan.</div></li><li><div>
Interact with the client to develop a trusting, supportive relationship while assisting the client in achieving identified goals.</div></li><li><div>
Advocate on behalf of individuals served</div></li><li><div>
Function fluently in usage of electronic health record system.</div></li><li><div>
Perform all duties in accordance with personnel policies and the program&rsquo;s fiscal guidelines</div></li><li><div>
Document all contact with clients and collaterals, and complete case activities</div></li><li><div>
Establish connections for families with necessary resources, and use listening, interviewing, and problem-solving techniques</div></li><li><div>
Work collaboratively with members of the team to ensure effective coordination of care.
</div></li><li><div>Perform all duties in accordance with personnel policies and the program&rsquo;s fiscal guidelines</div></li><li><div>
Other tasks assigned by the supervisor</div></li></ul><p>
</p><p></p><div><div><b>Minimum Qualifications:</b></div></div><ul><li><div>
Bachelor&rsquo;s degree in social work or a related Human Services field</div></li><li><div>
Two years of professional experience working in community-based services, providing care coordination.</div></li><li><div>
Knowledge of mental illness is preferred.</div></li><li><div>
Equipment Proficient use of desktop and laptop computers, smart phones and tablets, printers, fax machines, and photocopiers, as well as software including word processing, spreadsheet, and database programs.</div></li><li><div>
Reliable car and unrestricted driver's license with insurance $100,000/300,000 liability coverage</div></li></ul><p>
</p><div><div><b>Other Skills:</b></div></div><ul><li><div>
Excellent customer service and communication skills</div></li><li><div>
Works well independently and as a team member</div></li><li><div>
Multi-task efficiently and be flexible in all situations</div></li></ul><p>
</p><div><div><b>Driving and Vehicle Requirements:</b></div></div><ul><li><div>
Valid driver&rsquo;s license</div></li><li><div>
Reliable personal transportation</div></li><li><div>
Good driving record</div></li><li><div>
Minimum automobile insurance coverage of $100,00/$300,000 bodily injury liability</div></li></ul><p>
</p><div><div>If this describes YOU, please apply today!</div></div><div><div>
www.nyap.org/employment</div></div><p>
</p><div><div>Benefits listed are for eligible employees as outlined by our benefit policy.</div></div><p>
</p><div><div>The person in this position needs to follow a team concept and support both agency goals and co-workers. Employees must be able to effectively work with and be respectful and sensitive to persons from various cultures, socioeconomic, ethnic, religious, and racial backgrounds.</div></div><p>
</p><div><div><i>An Equal Opportunity Employer, including disability/veterans</i></div></div><p>
</p><div><div>National Youth Advocate Program has been serving communities and clients since 1978 and we continue to grow each year. Our growth allows us to expand and develop new and innovative programs to meet the ever-changing needs of those we serve. We offer unique and personalized services for families and individuals in four areas: Prevention/Intervention, Positive Youth Development, Out-of-Home-Placement and Reunification/Permanency.</div></div><div><div>
If YOU can envision it; WE can DO it! The possibilities are endless!</div></div><div><div>
We know you are compassionate and dedicated to serving your clients and communities and NYAP is dedicated to providing support to those who join our team! We look for individuals that are ready to make a direct impact and are excited to be an instrument in supporting the needs of our children, youth and families.</div></div></div>

Sentara

<div><b>Department and Name:</b> Care Management &ndash; SHP VA- Health Plan<br>
<b>Physical Location:</b> Lynchburg, VA<br>
<b>Location Type:</b> Remote<br>
<b>Employment Status:</b> Regular-Full time<br>
<b>Shift:</b> First (Days)<br>
<b>Posted Date:</b> March 17, 2026</div>
<br><div><div><div><h2 class="jobSectionHeader"><b>Job Overview</b></h2></div><div><div><div>
<div><p><b>Sentara Health Plans is hiring a Care Coordinator in Farmville,</b><b> Amelia Court House, Nottoway Court House, Dillwyn, Lunenburg, Chase City, Victoria and Cumberland</b><b> VA!</b></p>
<p><b>Status: Full-time position (40 hours/week)</b></p>
<p><b>Standard working hours: 8am to 5pm EST, MF</b></p>
<p><b>This position requires both in-person/face-to-face assessments and remote telephonic assessments for members with Serious Mental Illnesses, Serious Emotional Disturbances (ages 2+) and Substance Abuse Disorders!</b></p>
<p><b>Location: Applicants must be in</b><b> Farmville,</b> <b>Amelia Court House, Nottoway Court House, Dillwyn, Lunenburg, Chase City, Victoria and Cumberland</b><b> VA</b><b>! Travel may include up to 90 minutes one way.</b></p>
<p><b>Job responsibilities:</b></p>
<p>Performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. Must develop, participate and monitor multidisciplinary collaboration of services to patients where appropriate. Assist adult patients and their families with personal and environmental difficulties associated with medical condition up to and including at time of terminal illnesses.</p>
<p><b>Education:</b></p>
<ul><li>Must possess a degree in Health &amp; Human Services or one of the following related Fields:</li>
</ul><ul><li>Art Therapy</li><li>Behavioral Sciences</li><li>Child Development</li><li>Cognitive Sciences</li><li>Community Mental Health Counseling (MH, Vocational, Pastoral, etc.)</li><li>Counselor Education</li><li>Early Childhood Development</li><li>Educational Psychology</li><li>Gerontology</li><li>Healthcare Administration</li><li>Human Development</li><li>Human Services</li><li>Marriage and Family Therapy</li><li>Music Therapy</li><li>Nursing</li><li>Pharmacy</li><li>Psychiatric Rehabilitation</li><li>Psychology</li><li>Rehabilitation Counseling</li><li>Social Work</li><li>Sociology</li><li>Special Education</li><li>Speech Therapy</li><li>Therapeutic Recreation</li><li>Vocational Rehabilitation</li></ul>
<p>All degrees must be from schools that are listed as accredited on the U.S. Department of Education College Accreditation database found on the U.S. Department of Education website. Schools that are not listed on the database do not meet the standard as accredited. Degrees that have been obtained from schools outside the United States will be reviewed individually.</p>
<p><b>Certification/Licensure:</b></p>
<ul><li>None required</li>
</ul><p><b>Experience:</b></p>
<ul><li>Long Term Care- 1 year <b>(required)</b></li>
<li>Health Plan- 1 year; Medicaid- 1 year (preferred)</li>
<li>At least one year of mental health experience (preferred)</li></ul><br>
<p></p><p>Keywords: Talroo &ndash; Health Plan ,Care Coordination, Human Services, Community Health, Health Education, Long Term Care, Health Plan, Medicaid, Social Work, Therapy, Counseling, Psychology, Serious Mental Illnesses, Serious Emotional Disturbances, Substance Abuse Disorders, Mental Health, Behavioral Health</p>
</div></div></div></div></div><div><div><h2 class="jobSectionHeader"><b>About Us</b></h2></div><div><div>
<p>Sentara Health, an integrated, not-for-profit health care delivery system, celebrates more than 135 years in pursuit of its mission &ndash; &ldquo;we improve health every day.&rdquo; Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 34,000 employees, 12 hospitals in Virginia and Northeastern North Carolina including 10 hospitals with the prestigious Magnet&reg; recognition, and the Sentara Health Plans division which serves more than 1 million members in Virginia and Florida. Sentara is recognized nationally for clinical quality and safety, and is strategically focused on innovation and creating an extraordinary health care experience for our patients and members. Sentara was named a Health Quality Innovator of the Year (2024), was recognized by Forbes as &ldquo;America&rsquo;s Best-In-State Employer&rdquo; (2024), &ldquo;Best Employer for Veterans&rdquo; (2022, 2023), and &ldquo;Best Employer for Women&rdquo; (2020), and named to IBM Watson Health&rsquo;s &ldquo;Top 15 Health Systems&rdquo; (2021, 2018).</p>
<p>Learn more (Opens in a new tab)</p></div></div></div></div>

Blue Cross Blue Shield

<div><h1 class="jobSectionHeader"><b>Summary
</b><br>
</h1>We are currently hiring for a Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as a Case Management Coordinator, care management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience, especially when multiple health care providers and different care settings are involved. Taken collectively, care management interventions are intended to enhance client safety, well-being, and quality of life. These interventions carefully consider health care costs through the professional care manager's recommendations of cost-effective and efficient alternatives for care. Thus, effective care management directly and positively impacts the health care delivery system, especially in realizing the goals of the &quot;Triple Aim,&quot; which include improving the health outcomes of individuals and populations, enhancing the experience of health care, and reducing the cost of care. The professional care manager performs the primary functions of assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy. Integral to these functions is collaboration and ongoing communication with the client, client's family or family caregiver, and other health care professionals involved in the client's care.
<h1 class="jobSectionHeader"><br>
<b>Description<br>
</b><br>
</h1><p><b>Location
</b></p><p>This position is full-time (40 hours/week) Monday-Friday from <b>8:30am-5:00pm EST </b>and will be <b>fully remote.
</b></p><p></p><p><b>What You&rsquo;ll Do:
</b></p><ul><li><p>Provides active care management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals. Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions. Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high-risk pregnancy or other at-risk conditions that consist of: intensive assessment/evaluation of condition, at-risk education based on members&rsquo; identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement.
</p></li><li><p>Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify, initiate, and participate in on-site reviews. Serves as member advocate through continued communication and education. Promotes enrollment in care management programs and/or health and disease management programs.
</p></li><li><p>Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members.
</p></li><li><p>Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines. Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
</p></li><li><p>Maintains current knowledge of contracts and network status of all service providers and applies appropriately. Assists with claims information, discussion, and/or resolution and refers to appropriate internal support areas to ensure proper processing of authorized or unauthorized services.
</p></li></ul><p></p><p><b>To Qualify for This Position, You'll Need the Following:
</b></p><ul><li><p><b>Required Education: </b>Associates in a job-related field.
</p></li><li><p><b>Degree Equivalency: </b>Graduate of Accredited School of Nursing <b>OR </b>2 years job related work experience.
</p></li><li><p><b>Required Experience: </b>4 years recent clinical in defined specialty area. Specialty areas include: oncology, cardiology, neonatology, maternity, rehabilitation services, mental health/chemical dependency, orthopedics, general medicine/surgery. Or, 4 years utilization review/case management/clinical/or combination; 2 of the 4 years must be clinical.
</p></li><li><p><b>Required Skills and Abilities: </b>Working knowledge of word processing software.
</p></li><li><p>Knowledge of quality improvement processes and demonstrated ability with these activities.
</p></li><li><p>Knowledge of contract language and application.
</p></li><li><p>Ability to work independently, prioritize effectively, and make sound decisions.
</p></li><li><p>Good judgment skills.
 </p></li><li><p>Demonstrated customer service, organizational, and presentation skills.
</p></li><li><p>Demonstrated proficiency in spelling, punctuation, and grammar skills.
</p></li><li><p>Demonstrated oral and written communication skills.
</p></li><li><p>Ability to persuade, negotiate, or influence others.
</p></li><li><p>Analytical or critical thinking skills.
</p></li><li><p>Ability to handle confidential or sensitive information with discretion.
</p></li><li><p><b>Required Software and Tools: </b>Microsoft Office.
</p></li><li><p><b>Required License/Certificate: </b>An active, unrestricted RN license from the United States and in the state of hire OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) OR, active, unrestricted licensure as counselor, or psychologist from the United States and in the state of hire (in Div. 75 only). For Div. 75 and Div. 6B, except for CC 426: URAC recognized Case Management Certification must be obtained within 4 years of hire as a Case Manager.
</p></li></ul><p></p><p><b>We Prefer That You Have the Following:
</b></p><ul><li><p><b>Preferred Work Experience: </b>7 years-healthcare program management.
</p></li><li><p><b>Preferred Skills and Abilities: </b>Working knowledge of spreadsheet, database software. Thorough knowledge/understanding of claims/coding analysis, requirements, and processes.
</p></li><li><p><b>Preferred Licenses and Certificates: </b>Case Manager certification, clinical certification in specialty area.
</p></li></ul><p></p><p><b>Our Comprehensive Benefits Package Includes the Following:
</b></p><p>We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
</p><ul><li><p>Subsidized health plans, dental and vision coverage
</p></li><li><p>401k retirement savings plan with company match
</p></li><li><p>Life Insurance
</p></li><li><p>Paid Time Off (PTO)
</p></li><li><p>On-site cafeterias and fitness centers in major locations
</p></li><li><p>Education Assistance
</p></li><li><p>Service Recognition
</p></li><li><p>National discounts to movies, theaters, zoos, theme parks and more
</p></li></ul><p></p><p><b>What We Can Do for You:
</b></p><p>We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
</p><p></p><p><b>What To Expect Next:
</b></p><p>After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
</p><p></p><p>Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
</p><p></p><p><b>Pay Range Information:
</b></p><p></p><p><b>Range Minimum
 </b></p><p>$53,462.00
</p><p><b>Range Midpoint
 </b></p><p>$77,860.00
</p><p><b>Range Maximum
 </b></p><p>$102,258.00
</p><p></p><p><b>Pay Transparency Statement:
</b></p><p>Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.
</p><p><b>Equal Employment Opportunity Statement
</b></p><p></p><p>BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
</p><p></p><p>We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
</p><p></p><p>If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
</p><p></p><p>We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information .
</p><p></p><p>Some states have required notifications. Here's more information .</p></div>

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