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CVS Health · 22 hours ago

Analyst, Case Management - OhioRISE - Must reside in the Northeast Region of OH

Columbus, OH

Full-time

Hybrid

Entry Level

$21.10/hr - $36.78/hr

2+ years exp

CVS Health is the nation’s leading health solutions company, dedicated to transforming health care. The Analyst, Case Management role focuses on providing care coordination and support for members with complex behavioral health needs, ensuring appropriate healthcare outcomes through collaboration and case management processes.

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Responsibilities

Be clinically and culturally competent/responsive with training and experience necessary to manage complex cases in the community across child-serving systems

Through the use of care management tools and information/data review, 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/behavioral 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

Works collaboratively with the members' Child and Family Teams

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

Serves a single point of contact for members and assist members to remediate immediate and acute gaps in care and access

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

Qualification

Behavioral health experienceCase managementChildren's mental healthMS Office SuiteCommunity resources knowledgeMotivational interviewingCoaching skillsNegotiation skills

Required

2+ years of experience in behavioral health, social services, or human services

2+ years of experience with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint)

2+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a public sector human services or behavioral health care field, providing community-based services to children and youth, and their family/caregivers

2+ years experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development

2+ year of experience with Ohio delivery systems, including local community networks and resources

Willing and able to travel within the assigned region up to 50% of the time; Some travel to the New Albany office may be required for trainings/meetings

Reliable transportation required

Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm, as needed

Preferred

Case management and discharge planning experience

Managed Care experience

Medicaid 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

Paid time off

Flexible work schedules

Family leave

Dependent care resources

Colleague assistance programs

Tuition assistance

Retiree medical access