Analyst, Case Management

Job not on LinkedIn

🔥 36 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $21 - $44 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

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

• Conduct comprehensive evaluations of referred members’ needs and eligibility using care management tools and data review • Recommend case-resolution approaches and evaluate benefit plans and internal and external programs/services • Identify high-risk factors and service needs and make appropriate referrals to clinical case management or crisis intervention • 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 through established channels • Negotiate appropriate options and services to meet members’ benefits and healthcare needs • Use influencing and motivational interviewing skills to engage members and promote healthy lifestyle changes • Provide coaching, information, and support to empower members in healthcare and lifestyle decisions • 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 • Manage a full caseload of waiver members and conduct required in-person quarterly visits

🎯 Requirements

• Must reside in the state of Illinois in Macon County Illinois 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, eligible for mileage reimbursement as per company policy • Minimum of two (2) years of case management experience • Microsoft Office and electronic health record experience • Case management and discharge planning experience preferred • Managed Care experience preferred • Microsoft Office experience preferred • Bachelor’s degree or a non-licensed individual with a master’s degree, with either degree being in a human-services field, including sociology, special education, or rehabilitation counseling

🏖️ Benefits

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

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