[Remote] Analyst, Case Management at CVS Health

Georgia, Vermont, United States

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Not SpecifiedCompensation

Entry Level & New Grad, Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

2+ years experience in behavioral health or social services
Ability to work 8:00a-5:00p in assigned market time zone (EST/CST primarily)
2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook)
Bachelor's degree or non-licensed master level clinician in behavioral health or human services (psychology, social work, marriage and family therapy, counseling) preferred, or equivalent experience

Responsibilities

Conducts comprehensive evaluation of referred member's needs/eligibility using care management tools and data review, recommends approach to case resolution by evaluating benefit plan and available programs/services
Identifies high risk factors and service needs impacting member outcomes and care planning, refers 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 using holistic approach to overcome barriers to goals; presents cases at case conferences for multidisciplinary review 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 for optimum 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

Skills

Key technologies and capabilities for this role

Case ManagementCare Management ToolsMember EvaluationBenefit Plan AnalysisAppointment SchedulingCare Plan CoordinationCritical ThinkingHealthcare OutcomesRisk Factor IdentificationCrisis Intervention

Questions & Answers

Common questions about this position

Is this position remote or telework?

This is a full-time telework position open to candidates in the United States.

What is the work schedule for this role?

The schedule is Monday - Friday, 8:00a-5:00p in the assigned market time zone.

What key skills are needed for the Case Management Coordinator role?

The role requires critical thinking and judgment, negotiation skills, influencing/motivational interviewing skills, and the ability to conduct comprehensive evaluations using care management tools.

What is the salary or compensation for this position?

This information is not specified in the job description.

What makes a strong candidate for this Analyst, Case Management position?

Strong candidates will have experience in case management, the ability to collaborate with multidisciplinary teams, and skills in member engagement, care planning, and overcoming barriers to healthcare goals.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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