Case Management Analyst – Field

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Facilitate optimal healthcare outcomes for members through care coordination, support, and education.

• Perform thorough assessments of referred members' needs and eligibility utilizing care management tools and data analysis.

• Analyze benefit plans and both internal and external programs/services to propose case-resolution strategies.

• Recognize high-risk factors and service requirements, referring to clinical case management or crisis intervention when necessary.

• Coordinate and execute assigned care plan activities while monitoring progress.

• Collaborate with case managers, supervisors, Medical Directors, and other health programs to address barriers.

• Present cases during case conferences for multidisciplinary evaluation.

• Identify and escalate quality-of-care concerns through established procedures.

• Negotiate suitable options and services to fulfill members' benefits and healthcare needs.

• Employ influencing and motivational interviewing techniques to engage members and encourage lifestyle or behavioral changes.

• Offer coaching, information, and support to empower members in making independent medical and healthy lifestyle choices.

• Assist members in actively participating in healthcare decision-making with providers.

• Implement case management and quality management processes in accordance with regulatory, accreditation, and company standards.

⛳️ Requirements

• Must reside in St Clair County IL or nearby areas.

• Willing and able to travel 50-75% of the time to meet members in person.

• At least 2 years of experience in behavioral health, social services, or the human services field.

• A minimum of 2 years of case management experience.

• Experience in discharge planning is preferred.

• Managed care experience is preferred.

• Proficiency in Microsoft Office is preferred.

• A bachelor's degree or a non-licensed master's level clinician is required, with either degree being in behavioral health or human services (psychology, social work, marriage and family therapy, counseling).

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.