Analyst, Case Management

Job not on LinkedIn

🔥 13 hours ago

🌽 Illinois – Remote

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💵 $21 - $44 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

👻 Ghost score 0%

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Facilitate appropriate healthcare outcomes for waiver/LTSS members through care coordination, support, and education • Conduct comprehensive evaluations of referred members’ needs and eligibility • Recommend case-resolution approaches by evaluating benefit plans and internal and external programs/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 and implement assigned care-plan activities and monitor progress • Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers • Present cases at case conferences for multidisciplinary review • Identify and escalate quality-of-care issues • Negotiate appropriate options and services to meet 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 requirements • Travel 50–75% and conduct in-person quarterly member visits

🎯 Requirements

• Must reside in the state of Illinois in Rock Island area • Valid Illinois Driver’s license • Willing and able to travel up to 75% of their time to meet with members face to face • Reliable Transportation required • Minimum of two (2) years of case management experience • Microsoft Office and electronic health record experience • If managing HIV/AIDS HCBS Waiver members: experience working with racial and ethnic minorities and one or more of domestic abuse, the LGBTQ+ community, persons living with HIV/AIDS, or persons with substance use disorders • Case management and discharge planning experience preferred • Managed Care experience preferred • Bachelor’s degree or non-licensed master’s degree in a human-services field, including sociology, special education, or rehabilitation counseling

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay range • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility • Mileage reimbursement as per company policy

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