Field-Based Case Management Analyst (75% Travel)

CVS Health; Christiansburg (VA); On-site; USD 29,000 - 56,000; Full time

Job summary

CVS Health seeks an Analyst, Case Management to support the LTSS program from the Roanoke, VA region. This field-based role requires traveling up to 75% to meet members face to face and coordinate care.

Responsibilities include care coordination, evaluating member needs and benefit plans, and collaborating with case managers, physicians, and other health programs to ensure quality of care. Requires strong communication, organization, and commitment to member outcomes.

Qualifications

• 2 years' experience in behavioral health, social services or appropriate related field equivalent to program focus.
• Must reside in Roanoke Virginia or Surround Areas.
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy.

Responsibilities

• Utilizes critical thinking and judgment to collaborate and inform the case management process to facilitate appropriate healthcare outcomes for members.
• Identifies 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 healthcare needs.
• Utilizes 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 members to make ongoing independent medical and/or healthy lifestyle choices.
• Helps members 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.

Skills

Behavioral health

Social services

Travel readiness

Transportation

Education

Bachelor's or MSW related degree

LMHP QMHP LMSW LBSW MSW BSW certs

Job description

CVS Health seeks an Analyst, Case Management to support the LTSS program from the Roanoke, VA region. This field-based role requires traveling up to 75% to meet members face to face and coordinate care.

Responsibilities include care coordination, evaluating member needs and benefit plans, and collaborating with case managers, physicians, and other health programs to ensure quality of care. Requires strong communication, organization, and commitment to member outcomes.