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Case Management Analyst
2 months ago
At CVS Health, we are committed to delivering compassionate and personalized healthcare solutions. Our mission is to enhance the health and well-being of our communities through innovative services and support.
Position Overview:
This full-time remote position is designed for individuals in the United States, with a standard schedule of Monday to Friday, 8:00 AM to 5:00 PM EST.
Role Summary:
The Case Management Analyst plays a vital role in the healthcare delivery process by utilizing analytical skills and sound judgment to support case management initiatives. This position is essential in facilitating optimal healthcare outcomes for members, ensuring they receive the necessary assistance with scheduling appointments, understanding their benefits, and accessing educational resources.
Key Responsibilities:
1. **Member Evaluation:**
- Conduct thorough assessments of referred members' needs and eligibility using care management tools and data analysis.
- Identify high-risk factors and service requirements that may influence member outcomes, making appropriate referrals to clinical case management as needed.
2. **Enhancing Quality of Care:**
- Collaborate with case managers, supervisors, and medical professionals to address barriers to care and improve service delivery.
- Utilize negotiation skills to secure necessary services that align with members' healthcare needs.
3. **Monitoring and Documentation:**
- Adhere to regulatory and accreditation standards while utilizing case management processes.
- Maintain accurate documentation of care plans and member interactions to ensure compliance and quality assurance.
Qualifications:
- A minimum of 2 years of experience in behavioral health or social services, or a Bachelor's Degree in a related field.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
- Candidates must reside and work within the Eastern Standard Time zone.
Preferred Skills:
- Experience in case management and discharge planning.
- Familiarity with managed care environments.
Education Requirements:
- Bachelor's degree in behavioral health or human services is preferred, or equivalent experience.
Compensation and Benefits:
The typical pay range for this role is $42.91 per hour. This position is eligible for bonuses and other incentive programs, along with a comprehensive benefits package that includes medical, dental, and vision coverage, a 401(k) retirement plan, and paid time off.
CVS Health is dedicated to fostering a supportive work environment that values the well-being of our employees and the communities we serve.
