Case Management Analyst - Field in Harrisonburg, VA

CVS Health•Harrisonburg, VA

6d•Onsite

About The Position

This field-based Analyst, Case Management position is part of Aetna’s Long-Term Services and Supports (LTSS) team and is based in the Harrisonburg, Virginia region. The role requires frequent travel to meet with members face to face. The analyst supports members by coordinating care, providing education and support, assessing needs and eligibility, and connecting members with appropriate benefits, programs, and services. The position works with case managers, supervisors, Medical Directors, and other health programs to address barriers, improve quality of care, and help members achieve optimal health outcomes. The position is full-time, with 40 anticipated weekly hours. The typical pay range is $21.10–$40.90 per hour. The role is eligible for a CVS Health bonus, commission, or short-term incentive program, as well as a comprehensive benefits package for eligible colleagues.

Requirements

At least 2 years of experience in behavioral health, social services, or an appropriate related field equivalent to the program focus.
Must reside in Harrisonburg, Virginia, or surrounding areas.
Must have reliable transportation and be willing and able to travel up to 75% of the time.
Bachelor’s degree or a non-licensed master-level clinician is required, preferably in behavioral health or human services, such as psychology, social work, marriage and family therapy, or counseling.

Nice To Haves

Case management and discharge planning experience.
Managed care experience.
LTSS experience.
Certification in LMHP, QMHP, LMSW, LBSW, MSW, or BSW.

Responsibilities

Use critical thinking and judgment to collaborate on the case management process and facilitate appropriate healthcare outcomes through care coordination, support, and education.
Use care management tools and resources to evaluate members and conduct comprehensive assessments of member needs and eligibility.
Recommend approaches to case resolution and meeting member needs by evaluating benefit plans and available internal and external programs and services.
Identify risk factors and service needs that may affect outcomes or care planning, and refer members to clinical case management or crisis intervention as appropriate.
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 to obtain multidisciplinary review and support optimal outcomes.
Identify and escalate quality-of-care issues through established channels.
Use negotiation skills to secure appropriate options and services that meet members’ benefits and healthcare needs.
Use motivational interviewing to support member engagement and lifestyle or behavior changes.
Coach and empower members to make ongoing independent medical and healthy lifestyle choices.
Help members participate knowledgeably in healthcare decisions with their providers.
Use case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.