Analyst, Case Manager

Hispanic Alliance for Career Enhancement; Springfield (IL); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading health solutions company is seeking an Analyst in Case Management to support healthcare outcomes for members. This role involves comprehensive evaluation, coordination of care plans, and advocacy for members, requiring strong communication and organizational skills. The position is primarily remote with some travel required.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Wellness screenings and counseling programs

Tuition assistance

Qualifications

• Minimum 2 years of Case Management experience.
• 2+ years experience in Behavioral health or Social Services.
• Strong verbal and written communication skills.

Responsibilities

• Conducts comprehensive evaluation of Members using care management tools.
• Coordinates and implements assigned care plan activities.
• Utilizes negotiation skills to secure appropriate options and services.

Skills

Critical thinking

Negotiation skills

Motivational interviewing

Organizational skills

Communication skills

Education

Bachelor's degree in behavioral health or human services

Tools

MS Outlook

Excel

PowerPoint

Word

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

This will be a work from home position with travel up to 25% to meet members within Chicago area (Cook County IL) and occasional office-based meetings and/or trainings in Downers Grove IL as needed/requested by Management.

Preference for candidates residing in the Chicago area.

The Analyst, Case Mgt (ACM) utilizes critical thinking and professional judgment to support the case management process, in order to facilitate and maintain improved healthcare outcomes for members by providing advocacy, collaboration coordination, support and education for members through the use of care management tools and resources

• Conducts comprehensive evaluation of Members using care management tools and information/data review.

• Coordinates and implements assigned care plan activities and monitors care plan progress.
• 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.
• 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.
• 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 in order to achieve optimal outcomes.
• 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:

• In collaboration with the member and their care team develops and monitors established plans of care to meet the member's goals.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications

• Minimum 2 years of Case Management experience.

• 2+ years experience in Behavioral health or Social Services

• 3+ years computer proficiency (MS Outlook, Excel, PowerPoint, and Word) and must navigate multiple systems simultaneously

• Required to work the standard hours - 8:30am-5pm CST.

• Willing and able to travel up to 25% of their time in Chicago (Cook County) IL and surrounding areas.

Preferred Qualifications

• Managed Care Organization experience is strongly preferred.

• CCM Certification (Certified Case Manager) preferred
• Crisis intervention skills/experience
• Discharge Planning experience
• Strong organization and time management skills. Must be highly organized to manage continuously

changing priorities.
• Strong verbal and written communication skills.

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, counseling)

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$21.10 - $44.99

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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/16/2025

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