Experienced Case Management Analyst for Remote Health Care Coordination - CVS Health

Transforming Healthcare through Compassionate Case Management

At CVS Health, we're on a mission to redefine the way healthcare is delivered, making it more accessible, affordable, and personalized. As a leader in the healthcare industry, we're committed to improving the health and wellbeing of our members and communities. We're seeking an experienced Case Management Analyst to join our team as an Analyst, Case Management, playing a critical role in our CVS At Home Careers initiative. This part-time remote opportunity offers a competitive hourly rate of $30 and the chance to make a meaningful difference in the lives of our members.

About the Role

As an Analyst, Case Management, you will be the linchpin in our care coordination efforts, working closely with members, healthcare providers, and internal stakeholders to ensure seamless transitions and optimal health outcomes. Your expertise will be instrumental in assessing member needs, developing personalized care plans, and facilitating access to necessary resources and services. This role is a perfect fit for professionals passionate about delivering high-quality, patient-centered care and leveraging their analytical and communication skills to drive positive change.

Key Responsibilities

• Assessment of Members: Conduct comprehensive assessments of referred members' needs and qualifications using care management tools and data review, recommending a course of action for case resolution and addressing needs by evaluating members' benefit plans and available internal and external programs/services.
• Identification of High-Risk Factors: Identify high-risk factors and service needs that may impact member outcomes and care planning, referring members to clinical case management or crisis intervention as necessary.
• Care Plan Coordination: Facilitate and implement assigned care plan activities, monitoring progress and adjusting plans as needed to ensure optimal member outcomes.
• Clinical Appropriateness and Quality of Care: Collaborate with caseworkers, managers, Clinical Chiefs, and other health programs to overcome barriers to meeting goals and objectives, presenting cases at case conferences to secure multidisciplinary review and achieve optimal outcomes.
• Quality Issue Escalation: Identify and escalate quality of care issues through established channels, utilizing negotiation skills to secure appropriate decisions and services necessary to meet members' benefits and/or healthcare needs.
• Member Empowerment: Provide education, information, and support to empower members to make ongoing autonomous clinical and/or healthy lifestyle decisions, using influencing/inspirational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes.
• Monitoring, Evaluation, and Documentation: Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Essential Qualifications

• 2+ years of experience in behavioral health or social services, preferably in a case management or related role.
• 2+ years of experience with Microsoft Office applications (Word, Excel, Outlook).
• Bachelor's degree or higher in a relevant field such as psychology, social work, marriage and family therapy, or counseling.

Preferred Qualifications

• Case management and discharge planning experience.
• Managed Care experience.
• Non-authorized master's level clinician with a degree in behavioral health or human services.

Skills and Competencies

To succeed in this role, you will need:

• Strong analytical and problem-solving skills, with the ability to interpret complex data and make informed decisions.
• Excellent communication and interpersonal skills, with the ability to effectively collaborate with diverse stakeholders.
• Empathy and compassion, with a deep understanding of the needs and challenges faced by our members.
• Ability to work independently in a remote environment, with a strong self-motivation and discipline.

Career Growth Opportunities and Learning Benefits

At CVS Health, we're committed to the growth and development of our employees. As an Analyst, Case Management, you will have access to ongoing training and professional development opportunities, enabling you to expand your skills and expertise in care coordination and case management. Our comprehensive benefits package and competitive compensation reflect our appreciation for your hard work and dedication.

Work Environment and Company Culture

As a remote part-time employee, you will enjoy the flexibility and work-life balance that comes with working from home. Our culture is built on a foundation of compassion, innovation, and collaboration, with a strong emphasis on teamwork and mutual support. We're proud to be an equal opportunity employer, welcoming applications from diverse candidates who share our commitment to improving healthcare.

Compensation, Perks, and Benefits

We offer a competitive hourly rate of $30 for this part-time remote opportunity, along with a comprehensive benefits package that includes:

• Medical, dental, and vision coverage.
• Retirement savings plan with company match.
• Paid time off and holidays.
• Ongoing training and professional development opportunities.

Join Our Team

If you're a motivated and compassionate professional looking to make a meaningful difference in the lives of others, we encourage you to apply for this exciting opportunity. As an Analyst, Case Management, you will play a critical role in our CVS At Home Careers initiative, working closely with members, healthcare providers, and internal stakeholders to drive positive change and improve health outcomes. Apply now to join our team and start transforming healthcare today!