Case Management Analyst - Field

Job not on LinkedIn

🔥 13 hours ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $21 - $40 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Business Analyst

👻 Ghost score 0%

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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

• Collaborate and inform the case management process to facilitate appropriate healthcare outcomes for members • Provide care coordination, support, education, coaching, and information to members • Evaluate members’ needs and eligibility and recommend case-resolution approaches • Evaluate benefit plans and available internal and external programs/services • Identify risk factors and service needs and refer 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 • Negotiate appropriate options and services to meet members’ benefits and healthcare needs • Use motivational interviewing to promote member engagement and lifestyle/behavior changes • Help members participate knowledgeably in healthcare decision-making • Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements • Travel to meet members face to face in the Danville, Virginia region

🎯 Requirements

• 2 years’ experience in behavioral health, social services or appropriate related field equivalent to program focus • Must reside in Danville, Virginia or Surround Areas • Must possess reliable transportation • Must be willing and able to travel up to 75% of the time • Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) • Certification in LMHP, RN/LPN, QMHP, LMSW, LBSW, MSW or BSW preferred • Case management and discharge planning experience preferred • Managed Care experience preferred • LTSS experience preferred

🏖️ Benefits

• Mileage is reimbursed per our company expense reimbursement policy • Medical, dental, and 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 in addition to base pay range