Analyst, Case Management - Field

CVS Health; United States; Remote; USD 29,000 - 51,000; Full time

Job summary

CVS Health is seeking a field-based Care Manager for West Virginia with full-time telework. Residency in WV is required and travel 50%+ within the central region. You will evaluate member needs, coordinate care plans, and educate members to improve healthcare outcomes.

Join a team that collaborates with case managers and Medical Directors, upholds HIPAA guidelines, and uses care management tools to empower members in their health decisions.

Qualifications

• 2 years of experience in behavioral health or related field.
• West Virginia residency in Braxton, Calhoun, Clay, Fayette, Gilmer, Kanawha, Nicholas, Roane or Webster-Regional.
• Willingness to travel 50% or more within the central WV region.

Responsibilities

• Evaluate referred members’ needs and eligibility using care management tools.
• Coordinate and implement care plans with case managers and providers.
• Provide coaching and support to empower informed health decisions.
• Document activities in compliance with regulatory and company policies.

Skills

Behavioral health experience

MS Office Suite

Multi-system navigation

Reliable transportation

Travel readiness

Education

Bachelor’s degree in behavioral health or related field

Tools

MS Office Suite

SharePoint

Teams

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

This is a full-time field teleworker position that requires West Virginia residency. Travel is required 50% of the time or more, in the central region of WV. Field based travel locations may include member homes, residential treatment facilities, group homes, shelters, and detention facilities. Qualified candidates must reside in the region, in one of the following counties: Braxton, Calhoun, Clay, Fayette, Gilmer, Kanawha, Nicholas, Roane, Webster-Regional.

Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education for members through the use of care management tools and resources.

Schedule is Monday-Friday standard business hours. No nights, no weekends, and no holidays.

Evaluation of Members:
-Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.

• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates and implements assigned care plan activities and monitors care plan progress.

Enhancement of Medical Appropriateness and Quality of Care:

• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
  -Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilizes 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.
  -Helps member actively and knowledgably participate with their provider in healthcare decision-making.

Monitoring, Evaluation and Documentation of Care:

• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications

-2 years’ experience in behavioral health, social services, or appropriate related field equivalent to program focus
-West Virginia resident residing in one of the following counties: Braxton, Calhoun, Clay, Fayette, Gilmer, Kanawha, Nicholas, Roane, Webster-Regional
-Must possess reliable transportation and be willing and able to travel in the assigned region 50% or more of the time. Mileage is reimbursed per our company expense reimbursement policy.

• 2+ years of experience with personal computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)

Preferred Qualifications

• Medicaid experience.
• Waiver experience
• Foster care experience
• Crisis intervention skills
• Managed care/utilization review experience
• Case management and discharge planning experience
• Familiarity with QuickBase

Education

Bachelor’s degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling).

Work from Home Requirements:

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
• A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
• Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
• The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
• If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements:

• Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
• Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
• Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
• Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
• Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
• Future Growth: Openness to learning new skills in the future as the workplace environment evolves

Anticipated Weekly Hours

40

Time Type

Full time

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/31/2026

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