Case Management Analyst, Region 5

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

📋 Description

• Perform thorough evaluations to assess member needs, eligibility, barriers to care, and potential intervention opportunities.

• Deliver routine care coordination, support, and education to enhance health outcomes for members.

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

• Empower members to make informed healthcare choices and actively engage in their care plans.

• Collaborate with case managers, supervisors, medical directors, providers, and other healthcare professionals to meet member needs.

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

• Identify and escalate quality of care concerns through designated channels.

• Aid members in gaining access to appropriate services, benefits, and community resources.

• Exhibit strong negotiation skills to secure necessary services and support for members.

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

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

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

• Utilize technology and various systems efficiently to support member care and documentation needs.

• Independently manage workload while prioritizing organizational goals 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 combined with excellent problem-solving abilities.

• Outstanding verbal, written, and telephonic communication skills.

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

• Keen attention to detail with superior documentation capabilities.

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

• Highly organized and self-driven with the capacity to work independently with minimal oversight.

• Strong time management and multitasking skills.

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

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

• Willingness to travel up to 50% of the time within a 60-mile radius 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: Medicaid experience; Waiver program experience; Managed Care Organization (MCO) experience; Certified Case Manager (CCM) certification; Master's degree in healthcare, social services, or a 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; prior experience 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 supporting physical, emotional, and financial well-being.