Transition of Care Service Coordinator - Bexar County

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. Summary The Transition of Care Service Coordinator is responsible for care coordination of our members who are experiencing a significant change in health status which has resulted in an inpatient admission. The Transition of Care (TOC) Service Coordinator ensures the member experiences a seamless transition to their next care setting. Position Responsibilities Responsible for telephonic and/or face to face assessing, planning, implementing, and coordinating all care management activities with members to evaluate the medical and behavioral health needs to facilitate the member?s overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member?s overall wellness through integration. Using clinical tools and information/data review, conducts comprehensive assessments of member?s needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services. Applies clinical judgement to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. Complete assessments taking into account information from various sources to address conditions including co-morbid and multiple diagnosis that impact functionality and include the member?s restrictions/limitations. Ability to speak to medical and behavioral health professionals to influence appropriate member care. Use advanced clinical skills to perform crisis intervention with members experiencing a behavioral or medical crisis and refer them to the appropriate clinical providers for assessment and treatment as clinically indicated. Attends and participates in case rounds, including utilization management rounds for behavioral health and physical health to obtain multidisciplinary view to achieve optimal outcomes. Collaborates with the member, and inpatient facilities to coordinate discharge needs including ensuring post discharge needs are met. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Helps member actively and knowledgably participate with their provider in healthcare decision-making. In collaboration with the member and their care team develops and monitors established plans of care to meet the member?s goals. Utilizes care management processes in compliance with regulatory and company policies and procedures. Follows members identified as inpatient in hospitals (whether planned or unplanned admission) and throughout subsequent care continuum. Facilitates clinical hand offs during transitions of care. Reports to: Manager, Clinical Health Services Required Qualifications: Active current unrestricted RN licensure in the state of Texas OR Licensed Social Worker in the state of Texas Must reside in Bexar County or adjacent county 3+ years clinical practice experience, e.g. hospital setting 3+ years of discharge planning experience 2+ years? experience managing complex medical 2+ years behavioral health conditions Willing and able to travel 50% of their time to meet members face to face in the Bexar County area. Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy 2+ years? experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) Preferred Qualifications: Behavioral Health Experience Case management in an integrated model Experience providing care to the Medicaid population Bilingual in Spanish Education: RN license: Minimum of an Associate's in Nursing required BH License: Minimum of a Master's degree in social work or related field required Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company?s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (?PTO?) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 03/01/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.