[Remote] Analyst, Case Management (EST) at CVS Health

Connecticut, 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 in behavioral health, social services, or a related field relevant to the program focus
Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) and capable of utilizing these tools effectively in the CM Coordinator role
Access to a private, dedicated workspace to fulfill job requirements effectively
High School Diploma with equivalent experience (REQUIRED)
Associate’s or Bachelor’s Degree (preferred)

Responsibilities

Conduct the annual Health Risk Survey to support needs identification for the member’s Individual Plan of Care
Inform the assigned care manager of newly identified health/safety risks or service needs
Complete care coordination activities delegated by the care manager within an established timeframe
Inform the assigned care manager and/or associate manager of any identified quality of care issues
Passionately support the member’s care coordination needs and drive solutions to address those needs
Use problem-solving skills to find alternative contact information for members who are unreachable by care management
Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health
Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies
Meet performance and productivity metrics, including call volume, successful member engagement, and compliance with state/federal regulatory requirements

Skills

Care Coordination

Health Risk Survey

Social Determinants of Health

Care Management

Medicare

Medicaid

DSNP

SNP

Individual Plan of Care

Risk Escalation

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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