Case Management Analyst at CVS Health

Northfield, Massachusetts, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Demonstrated attention to detail
Ability to travel up to 50% of time
Ability to interface with customers/clients
0-2 years work experience
Bachelor's degree preferred

Responsibilities

Consults with case managers, supervisors, medical directors and/or other health programs using a holistic approach, to overcome barriers to meeting goals and objectives
Presents cases at case conferences to obtain a multidisciplinary review in order to achieve optimal outcomes
Identifies and escalates quality of care issues through established channels
Demonstrates negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
Delivers 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
Assists in encouraging members to actively participate with their provider in healthcare decision-making
Conducts comprehensive evaluations of referred members’ needs/eligibility using care management tools and recommends an approach to case resolution
Conducts routine care coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes for members
Helps implement projects, programs, and processes for Case Management
Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area

Skills

Care Coordination

Case Management

Negotiation

Motivational Interviewing

Case Conferences

Quality of Care 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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