Analyst, Case Managment- Field

CVS Health • Hammond, LA

4d • $21 - $37

About The Position

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Must reside within this region to be considered: Region 8: Union, Morehouse, Lincoln, Jackson, Ouachita, Caldwell, Richland, Franklin, Tensas, Madison, East Carroll, West Carroll Position Summary 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. A Brief Overview 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. What you will do 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. For this role you will need

Requirements

• Demonstrated attention to detail.
• Ability to travel up to 50% of time.
• Ability to interface with customers/clients.
• 2+ years' experience in behavioral health, social services or appropriate related field equivalent to program focus.
• 2+ years' experience with adult and/or adolescent populations.
• Must reside in Louisiana

Nice To Haves

• Medicaid experience.
• Waiver experience
• Crisis intervention skills
• Managed care/utilization review experience
• Familiarity with QuickBase
• Case management and discharge planning experience
• Demonstrated proficiency with personal computer, keyboard navigation, and mouse
• Familiarity and proficiency with MS Office Suite applications including MS Teams, Outlook, Word, Excel, and SharePoint.

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.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
• For more information, visit https://jobs.cvshealth.com/us/en/benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees