Case Management Analyst

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

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.

What You Will Do

• Consults with case managers, supervisors, medical directors and / or other health programs using a holistic approach, to overcome barriers to meeting goals and objectives.
• 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

Bachelor's degree preferred.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$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

We anticipate the application window for this opening will close on : 11 / 30 / 2025.

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

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