Case Management Analyst - Field in the West Side of Chicago, IL - New Hire Bonus Available

CVS Health•Oak Park, IL

2d•$21 - $45•Hybrid

About The Position

This field-based Case Management Analyst position is part of Aetna’s Long-Term Services & Supports (LTSS) team and serves waiver members in the west side of Chicago area of Illinois. The role carries a full caseload and requires travel 50–75% of the time for face-to-face member meetings, including in-person quarterly visits. The position supports contractual requirements and facilitates appropriate healthcare outcomes through care coordination, support, and education using care management tools and resources. The analyst evaluates referred members’ needs and eligibility, reviews benefit plans and available programs and services, identifies high-risk factors and service needs, and recommends approaches to case resolution. The role coordinates and monitors care-plan activities, collaborates with case managers, supervisors, Medical Directors, and other health programs, and presents cases for multidisciplinary review. It also supports member engagement and informed healthcare decisions through negotiation, motivational interviewing, coaching, information, and referrals, while escalating quality-of-care issues and documenting work in accordance with regulatory, accreditation, and company requirements. The position is home-based, subject to specified internet, workspace, security, and in-state work-location requirements. CVS Health provides computer equipment and related peripherals; colleagues provide their own desk or standing desk. The role is full-time, with 40 anticipated weekly hours. Mileage for travel is reimbursed under the company expense reimbursement policy. A new-hire bonus is available, and the position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay.

Requirements

Must reside in Illinois in the west side of the Chicago area.
Valid Illinois driver’s license.
Reliable transportation and willingness and ability to travel up to 75% of the time.
At least two years of case management experience.
Experience with Microsoft Office and electronic health records.
A bachelor’s degree in a human-services field, or a master’s degree in a human-services field for a non-licensed individual. Listed examples include sociology, special education, and rehabilitation counseling.
Ability to meet work-from-home requirements: direct/hardwired internet connection to a modem or router within seven feet of the computer, at least 25 Mbps download and 3 Mbps upload, and no Wi-Fi or satellite internet.
Ability to maintain a quiet, secure, private, tidy, organized home workspace compliant with CVS Health and HIPAA guidelines and suitable for uninterrupted work.
Work-from-home colleagues must work within the state and city where they have confirmed they currently live.
Ability to use multiple monitors and navigate multiple applications simultaneously.
Ability to communicate through email, calendar invitations, Teams messaging, and virtual meetings.
Experience with Microsoft Office 365 applications (Teams, Outlook, Word, Excel, PowerPoint) or similar tools such as Google Workspace.
Ability to access secure systems such as a VPN and EHR portal and follow security practices, including locking an unattended computer, managing strong passwords, and recognizing suspicious emails or links.
Ability to troubleshoot common technical issues independently and contact IT for unresolved technical issues.
Openness to learning new skills as the workplace environment evolves.
If hired, commitment to obtaining the required internet speeds and adhering to work-from-home requirements.

Nice To Haves

Case management and discharge planning experience.
Managed care experience.
Microsoft Office experience.
Experience working with the HIV and AIDS population.
Multilingual language proficiency.

Responsibilities

Evaluate referred members’ needs and eligibility using care management tools and information and data review.
Review members’ benefit plans and available internal and external programs and services to recommend approaches to resolving cases and meeting needs.
Identify high-risk factors and service needs that may affect member outcomes and care planning, and make appropriate referrals to clinical case management or crisis intervention.
Coordinate and implement assigned care-plan activities and monitor progress.
Consult with case managers, supervisors, Medical Directors, and other health programs to address barriers to goals and objectives.
Present cases at case conferences for multidisciplinary review and optimal outcomes.
Identify and escalate quality-of-care issues through established channels.
Use negotiation to secure appropriate options and services for members’ benefits and healthcare needs.
Use influencing and motivational interviewing skills to support member engagement and lifestyle or behavior changes.
Provide coaching, information, and support so members can make ongoing independent medical and healthy-lifestyle choices.
Help members participate actively and knowledgeably with their providers in healthcare decisions.
Use case-management and quality-management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Conduct face-to-face member visits, including required in-person quarterly visits, while managing a full waiver-member caseload.
Travel within the assigned service area for member visits; mileage is reimbursed under the company expense reimbursement policy.

Benefits

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources based on eligibility
New-hire bonus available
Eligibility for a CVS Health bonus, commission, or short-term incentive program
Mileage reimbursement for work travel
Company-provided computer equipment, including keyboard, monitor, computer, and headset