Analyst, Case Management

Posted:
12/10/2024, 11:07:55 AM

Location(s):
Ohio, United States ⋅ Columbus, Ohio, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Medical, Clinical & Veterinary

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

  • Conducts routine care coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes for members. Helps implement projects, programs, and processes for Case Management. Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area.
  • A Brief Overview
    Conducts routine care coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes for members. Helps implement projects, programs, and processes for Case Management. Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area.

    What you will do
    • Consults with case managers, supervisors, medical directors and/or other health programs using a holistic approach, to overcome barriers to meeting goals and objectives.
    • Presents cases at case conferences to obtain a multidisciplinary review in order to achieve optimal outcomes.
    • Identifies and escalates quality of care issues through established channels.
    • Demonstrates negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
    • Delivers 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.
    • Assists in encouraging members to actively participate with their provider in healthcare decision-making.
    • Conducts comprehensive evaluations of referred members’ needs/eligibility using care management tools and recommends an approach to case resolution.


Required Qualifications

  • Demonstrated attention to detail.
  • Ability to travel up to 50% of time.
  • Ability to interface with customers/clients.
  • 0-2 years work experience


Preferred Qualifications

Education

Bachelor's degree or equivalent work experience preferred.

Pay Range

The typical pay range for this role is:

$21.10 - $36.78

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 12/31/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.