Management Analyst Jobs

About The Position

Requirements

• 2 years’ experience in behavioral health, social services, or appropriate related field equivalent to program focus
• West Virginia resident residing in one of the following counties: Morgan, Jefferson, Berkeley, Hampshire, Mineral, Grant, Hardy, Pendleton, Randolph, Tucker, and Preston.
• Must possess reliable transportation and be willing and able to travel in the assigned region 50% or more of the time.
• 2+ years of experience with personal computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)
• Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling).

Nice To Haves

• Medicaid experience.
• Waiver experience
• Foster care experience
• Crisis intervention skills
• Managed care/utilization review experience
• Case management and discharge planning experience
• Familiarity with QuickBase

Responsibilities

• Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
• Identifies 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.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilizes 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.
• Helps member actively and knowledgeably participate with their provider in healthcare decision-making.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Benefits

• comprehensive and competitive mix of pay and benefits
• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility
• CVS Health bonus, commission or short-term incentive program