Case Management Analyst, Region 5

Job not on LinkedIn

🔥 8 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $21 - $36 / 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

• Conduct comprehensive assessments to evaluate member needs, eligibility, barriers to care, and opportunities for intervention • Provide routine care coordination, support, and education to members to improve health outcomes • Utilize motivational interviewing techniques to increase member engagement and promote healthy lifestyle changes • Empower members to make informed healthcare decisions and actively participate in their care plans • Collaborate with case managers, supervisors, medical directors, providers, and other healthcare professionals to address member needs • Present cases at interdisciplinary case conferences to support optimal member outcomes • Identify and escalate quality of care concerns through established channels • Assist members in accessing appropriate services, benefits, and community resources • Demonstrate effective negotiation skills to secure services and support necessary to meet member needs • Maintain accurate, timely, and compliant documentation of all case management activities • Meet productivity, quality, and performance metrics while managing a diverse caseload • Support implementation of case management programs, projects, policies, and processes • Utilize technology and multiple systems effectively to support member care and documentation requirements • Manage workload independently while maintaining organizational priorities and deadlines

🎯 Requirements

• Minimum of two (2) years of experience in case management, behavioral health, social services, healthcare, or a related field • Experience working with adult and/or adolescent populations • Strong customer service orientation with excellent problem-solving skills • Excellent verbal, written, and telephonic communication skills • Demonstrated motivational interviewing skills and ability to establish rapport and trust telephonically • Strong attention to detail with exceptional documentation skills • Commitment to compliance, regulatory requirements, and quality standards • Highly organized and self-motivated with the ability to work independently with minimal supervision • Strong time management and multitasking abilities • Proficiency with computers and technology platforms used for case management and documentation • Ability to interface effectively with members, providers, and internal stakeholders • Ability to travel up to 50% of the time within 60 miles one way • Must reside in Louisiana • Ability to work a variable schedule, including two evenings per week until 9:00 PM local time • Ability to meet established performance and productivity metrics • Required: Bachelor's Degree in Healthcare, Human Services, Social Work, Psychology, Sociology, Public Health, or a related field • Preferred: Medicaid experience; Waiver program experience; Managed Care Organization (MCO) experience; Certified Case Manager (CCM) certification; Master's degree in a healthcare, social services, or related field; crisis intervention experience and skills; utilization review experience; case management and discharge planning experience; QuickBase or similar case management platforms; Microsoft Teams, Outlook, Word, Excel, and SharePoint; previous experience coordinating care for complex populations

🏖️ Benefits

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