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CVS Health · 3 weeks ago

Analyst, Case Management – Field – Must reside in Winnebago County Illinois

IL - Roscoe

Full-time

Onsite

Entry, Mid Level

$21.10/hr - $44.99/hr

2+ years exp

CVS Health is the nation’s leading health solutions company, reaching millions of Americans through local presence and digital channels. The Analyst, Case Management Field position involves managing a full caseload of waiver members, providing care coordination, support, and education through face-to-face interactions and comprehensive evaluations.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Conducts comprehensive evaluation of referred members' needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members' benefit plan and available internal aid 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

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 knowledgeably 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

Case management experienceElectronic health record experienceMicrosoft OfficeManaged Care experienceDischarge planning experienceMotivational interviewingNegotiation skills

Required

Must reside in the state of Illinois in Winnebago County IL or Surrounding Areas

Case management experience

Microsoft Office and electronic health record experience

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

Preferred

Case management and discharge planning experience preferred (2 years)

Managed Care experience preferred

Microsoft Office experience preferred

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