Analyst, Case Management (Hybrid, Illinois)

CVS Health • Bloomington, IL

77d • $21 - $44 • Hybrid

About The Position

The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.

Requirements

• 2 years experience in behavioral health, social services or appropriate related field equivalent to program focus.
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually.
• Excellent analytical and problem-solving skills.
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently in an autonomous environment; self starter.
• Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
• Efficient and Effective computer skills including navigating multiple systems and keyboarding.
• Must possess reliable transportation and be willing and able to travel up to 10% of the time.

Nice To Haves

• Case management and discharge planning experience.
• Managed Care experience preferred.

Responsibilities

• Conduct comprehensive evaluation of referred member's needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
• Identify 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.
• Coordinate and implement assigned care plan activities and monitor care plan progress.
• Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives.
• Present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Help member actively and knowledgably participate with their provider in healthcare decision-making.
• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees