Case Management Analyst – Field

Job not on LinkedIn

🔥 1 hour ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $21 - $44 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Business Analyst

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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

• Facilitate appropriate healthcare outcomes for members through care coordination, support and education • Conduct comprehensive evaluations of referred members' needs and eligibility using care management tools and data review • Evaluate benefit plans and internal and external programs/services to recommend case-resolution approaches • Identify high-risk factors and service needs, with referral to clinical case management or crisis intervention as 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 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 lifestyle or behavior changes • Provide coaching, information and support to empower 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

🎯 Requirements

• Must reside in St Clair County IL or Surrounding Areas • Willing and able to travel 50-75% of the time to meet members face to face • Minimum 2 years of experience in behavioral health, social services or human services field • Minimum 2 years of case Management experience • Discharge Planning experience preferred • Managed Care experience preferred • Microsoft Office experience preferred • Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (psychology, social work, marriage and family therapy, 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 • CVS Health bonus, commission or short-term incentive program eligibility

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