Case Management Analyst - Field in Danville, VA

CVS Health•Danville, VA

4d•$21 - $41•Onsite

About The Position

This Analyst, Case Management position is with Aetna’s Long-Term Services and Supports (LTSS) team and is field-based in the Danville, Virginia region. The role requires frequent travel to meet with members face to face; the posting states travel of 70% in the position summary and up to 75% in the required qualifications. Mileage is reimbursed under the company expense reimbursement policy. The analyst collaborates in the case management process to facilitate appropriate healthcare outcomes for members through care coordination, support, and education. The role evaluates member needs and eligibility, identifies risks and service needs, coordinates care plan activities, monitors progress, and works with clinical and other health program colleagues to address barriers. The analyst also supports member engagement and informed healthcare decision-making while following regulatory, accreditation, and company requirements. 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, in addition to the base pay range. Benefits for eligible colleagues include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources.

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 Danville, 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 non-licensed master-level clinician required.

Nice To Haves

Case management and discharge planning experience.
Managed care experience.
Long-Term Services and Supports (LTSS) experience.
Degree in behavioral health or human services, such as psychology, social work, marriage and family therapy, or counseling.
Certification in LMHP, RN/LPN, QMHP, LMSW, LBSW, MSW, or BSW.

Responsibilities

Collaborate in the case management process to facilitate appropriate healthcare outcomes through care coordination, support, and education.
Use care management tools and information to evaluate members, assess needs and eligibility, and recommend case-resolution approaches using available benefits and programs.
Identify risk factors and service needs that may affect member outcomes and care planning, and refer members to clinical case management or crisis intervention when appropriate.
Coordinate and implement assigned care plan activities and monitor care plan progress.
Consult with case managers, supervisors, Medical Directors, and other health programs to address barriers to care goals; present cases at case conferences for multidisciplinary review.
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 promote member engagement and lifestyle or behavior changes.
Provide coaching, information, and support that empower members to make independent medical and healthy lifestyle choices.
Help members participate actively and 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.
Travel to meet members face to face in the Danville, Virginia region.