AnalystCase Mgt

About the position Responsibilities • Coordinate, document, and communicate all aspects of the utilization/benefit management program. • Conduct comprehensive evaluations of referred members' needs and eligibility. • Recommend approaches to case resolution and meeting members' needs by evaluating their benefit plans. • Identify high-risk factors and service needs that may impact member outcomes and care planning components. • Coordinate and implement assigned care plan activities and monitor care plan progress. • Present cases at case conferences for multidisciplinary review to achieve optimal outcomes. • Identify and escalate quality of care issues through established channels. • Utilize negotiation skills to secure appropriate options and services for members. • Utilize influencing and motivational interviewing skills to ensure maximum member engagement. • Provide coaching, information, and support to empower members to make informed medical and lifestyle choices. • Monitor and document care in compliance with regulatory and accreditation guidelines. Requirements • 2+ years' Case Management experience working with individuals designated as having a serious mental illness (SMI) and with elderly or physically disabled individuals. • Strong organization, collaboration, and time management skills. Nice-to-haves • Computer proficiency with Outlook, Windows, and Word. • Experience collaborating with medical professionals. • Additional Case Management experience. Benefits • Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Numerous well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with participating partners. • Paid Time Off (PTO) and paid holidays. Apply tot his job Apply To this Job