Analyst in case management focusing on healthcare outcomes for members at CVS Health. Collaborating and coordinating care plans to meet member needs and improve overall health.
Responsibilities
Utilizes critical thinking and judgment to collaborate and inform the case management process
Conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution
Coordinates and implements assigned care plan activities and monitors care plan progress
Consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives
Identifies and escalates quality of care issues through established channels
Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
Helps member actively and knowledgably participate with their provider in healthcare decision-making
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Requirements
Candidate must reside in Falls Church or Annandale Virginia or Surrounding Areas
2 years’ experience in behavioral health, social services or appropriate related field equivalent to program focus
Must possess reliable transportation and be willing and able to travel up to 70-75% of the time within Northern Virginia Region
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling)
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
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