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Care Management Analyst
2 months ago
About CVS Health:
At CVS Health, we are dedicated to enhancing the health and well-being of our communities. Our mission is to provide personalized health care solutions that are accessible and affordable, ensuring that every individual receives the care they deserve.
Position Overview:
The Case Management Specialist plays a vital role within our Care Team, focusing on the management of members enrolled in our Dual Special Needs Plan. This position is tailored for individuals with limited health conditions, typically categorized as low risk. Collaborating closely with Nurse Care Managers, Care Coordinators, Transition of Care Coaches, and other team members, the Case Management Specialist aims to improve health outcomes, address social determinants of health, and connect members with essential community resources.
Key Responsibilities:
- Engage with low-risk members through phone interactions, coordinating care and conducting assessments to develop and update individualized care plans.
- Create comprehensive care plans based on assessments and claims data, ensuring they align with the members' needs.
- Participate actively in Interdisciplinary Team meetings to discuss members' health care requirements and identify barriers to care.
- Facilitate connections between members and available health plan benefits and community resources.
- Perform necessary administrative tasks to maintain the skills required for effective job performance.
Essential Qualifications:
- Consistent and reliable attendance.
- Familiarity with community resources and services.
- Strong organizational abilities and the capacity to work independently.
- Ability to maintain professional relationships with members and colleagues.
- Effective verbal and written communication skills.
- Proficiency in computer systems, particularly Microsoft Office.
- Excellent customer service skills.
- A dedicated workspace for remote work.
Work Environment:
This position is remote, with a requirement to reside in the Eastern Standard Time (EST) zone. Standard working hours are Monday through Friday, from 8 AM to 5 PM EST.
Qualifications:
Required: Minimum of 3 years of experience in a health-related field.
Preferred: Relevant certifications such as CRC, CDMS, CRRN, COHN, or CCM; experience with Medicare and Medicaid; familiarity with managed care; and experience working with geriatric special needs, behavioral health, and disabled populations.
Education:
A Bachelor's Degree or equivalent experience is required.
Compensation and Benefits:
The typical pay range for this role is $44.99 per hour. This range represents the base hourly rate or base annual full-time salary for all positions within this job grade. The actual salary offer will depend on various factors, including experience, education, and geography. In addition to base pay, eligible employees may participate in bonus programs and benefit from a comprehensive range of medical, dental, and vision benefits, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. CVS Health also provides fully-paid term life insurance, short-term and long-term disability benefits, and various well-being programs.
Diversity and Inclusion:
CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruitment, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable law.
