Case Management Analyst, Region 1

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

📋 Description

• Perform thorough assessments to determine member needs, eligibility, barriers to care, and potential intervention opportunities.

• Offer ongoing care coordination, support, and education to members aimed at enhancing health outcomes.

• Apply motivational interviewing techniques to boost member engagement and encourage healthy lifestyle changes.

• Enable members to make informed decisions regarding their healthcare and actively participate in their care plans.

• Work in collaboration with case managers, supervisors, medical directors, providers, and other healthcare professionals.

• Present cases during interdisciplinary case conferences to facilitate optimal outcomes for members.

• Recognize and escalate quality of care issues through established channels.

• Assist members in accessing the appropriate services, benefits, and community resources.

• Negotiate to obtain services and support needed to fulfill member requirements.

• Ensure the maintenance of accurate, timely, and compliant documentation of case management activities.

• Achieve productivity, quality, and performance metrics while managing a varied caseload.

• Support the implementation of case management programs, projects, policies, and procedures.

• Employ technology and various systems for member care and documentation purposes.

• Independently manage workload while adhering to organizational priorities and deadlines.

⛳️ Requirements

• At least two (2) years of experience in case management, behavioral health, social services, healthcare, or a related field.

• Experience working with adult and/or adolescent populations.

• Strong customer service focus complemented by excellent problem-solving abilities.

• Exceptional verbal, written, and telephonic communication skills.

• Proven motivational interviewing skills with the capability to build rapport and trust over the phone.

• High attention to detail with outstanding documentation proficiency.

• Commitment to compliance, regulatory requirements, and quality standards.

• Highly organized and self-driven with the ability to work independently with minimal supervision.

• Strong abilities in time management and multitasking.

• Proficient with computers and technology platforms utilized for case management and documentation.

• Ability to effectively engage with members, providers, and internal stakeholders.

• Willingness to travel up to 50% of the time within 60 miles one way.

• Must be a resident of Louisiana.

• Flexibility to work a variable schedule, including two evenings per week until 9:00 PM local time.

• Capability to meet established performance and productivity metrics.

• Required: Bachelor's Degree in Healthcare, Human Services, Social Work, Psychology, Sociology, Public Health, or a related field.

• Preferred: Experience with Medicaid; experience in waiver programs; Managed Care Organization (MCO) experience; Certified Case Manager (CCM) certification; a Master’s degree in a healthcare, social services, or related field; crisis intervention experience and skills; utilization review experience; case management and discharge planning experience; familiarity with QuickBase or similar case management platforms; proficiency in Microsoft Teams, Outlook, Word, Excel, and SharePoint; previous experience in coordinating care for complex populations.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being, based on eligibility.