Field Case Management Analyst - 70% Travel (VA)

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health, in Virginia, seeks a full-time Health Services Case Manager to coordinate care, educate members, and support healthcare outcomes through case management tools and resources. The role requires 2 years in behavioral health or related field and residency in Central Virginia with up to 70% travel in the Central region.

The ideal candidate will evaluate member needs, coordinate care plans, and collaborate with clinical teams to overcome barriers to care while promoting healthy lifestyle

Qualifications

• 2 years' experience in behavioral health, social services or appropriate related field equivalent to program focus
• Must reside in Central Virginia Area
• Up to 70% travel will be required in Central region

Responsibilities

• 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 using care management tools and resources.
• Uses care management tools and information to evaluate members, conducts comprehensive evaluation of 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 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.

Skills

Case management

Care coordination

Motivational interviewing

Behavioral health

Communication

Education

Bachelor's degree or non-licensed master's in behavioral health or human services

Job description

CVS Health, in Virginia, seeks a full-time Health Services Case Manager to coordinate care, educate members, and support healthcare outcomes through case management tools and resources. The role requires 2 years in behavioral health or related field and residency in Central Virginia with up to 70% travel in the Central region.

The ideal candidate will evaluate member needs, coordinate care plans, and collaborate with clinical teams to overcome barriers to care while promoting healthy lifestyle