Case Management Analyst

Case Management Analyst – CVS Health

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Position Summary

Conducts routine care coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes for members. Helps implement projects, programs, and processes for Case Management. Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area.

Location & Resident Requirements

Candidate must reside in Kentucky in the following counties : Pikeville, Bowling Green / Owensboro, Paducah, Somerset / London.

Responsibilities

• Consults with case managers, supervisors, medical directors and / or other health programs using a holistic approach.
• Presents cases at case conferences to obtain a multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Demonstrates negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and / or healthcare needs.
• Delivers 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.
• Assists in encouraging members to actively participate with their provider in healthcare decision-making.
• Conducts comprehensive evaluations of referred members’ needs / eligibility using care management tools and recommends an approach to case resolution.

Required Qualifications

Education

High School Diploma and 2+ years of college (Associate's degree).

Preferred Qualifications

Bachelor's Degree, 2-4 years case management and discharge planning experience preferred.

Anticipated Weekly Hours

40 hours per week.

Time Type

Full time.

Pay Range

The typical pay range for this role is $21.10 - $36.78 per hour. 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.

Great Benefits for Great People

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

Application window closes on : 10 / 31 / 2025.

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