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CVS Health · 9 hours ago

Analyst, Case Management - Must reside in IL

IL - Vernon Hills

Full-time

Hybrid

Entry, Mid Level

$21.10/hr - $44.99/hr

2+ years exp

CVS Health is the nation’s leading health solutions company, dedicated to transforming healthcare for millions of Americans. The Case Management Coordinator will utilize critical thinking to facilitate healthcare outcomes by assisting members in accessing benefits and coordinating care plans.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services

Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate

Coordinates and implements assigned care plan activities and monitors care plan progress

Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes

Identifies and escalates quality of care issues through established channels

Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs

Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health

Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices

Helps member actively and knowledgably participate with their provider in healthcare decision-making

Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Qualification

Behavioral health experienceCase management experienceAnalytical skillsMS OfficeEffective communicationIndependent workingMotivational interviewingOrganizational skillsInterpersonal skills

Required

Candidate must reside in Illinois

2+ years' experience in behavioral health, social services or appropriate related field equivalent to program focus

Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually

Excellent analytical and problem-solving skills

Effective communications, organizational, and interpersonal skills

Ability to work independently

Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications

Efficient and effective computer skills including navigating multiple systems and keyboarding

Bachelor's Degree or non-licensed master level clinician, with either degree being in behavioral health or human services (nursing, psychology, social work, marriage and family therapy, counseling)

Preferred

Case management and discharge planning experience

Managed care experience

Benefits

Affordable medical plan options

401(k) plan (including matching company contributions)

Employee stock purchase plan

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility