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CVS Health

Runs pharmacies, health plans and clinics

Case Management Analyst - Long-Term Services and Supports

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeDanville, VA, USA

About the Job

Requirements

  • At least 2 years of experience in behavioral health, social services, or an appropriate related field equivalent to the program focus.
  • Must reside in Danville, Virginia, or surrounding areas.
  • Must have reliable transportation and be willing and able to travel up to 75% of the time.
  • A bachelor's degree or a non-licensed master's-level clinician qualification is required.

Responsibilities

  • Use critical thinking and judgment to collaborate in and inform the case management process, facilitating appropriate healthcare outcomes through care coordination, support, and education using care management tools and resources.
  • Use care management tools and information to evaluate members; comprehensively assess member needs and eligibility; and recommend case-resolution approaches or ways to meet needs by evaluating benefit plans and available internal and external programs and services.
  • Identify risk factors and service needs that may affect member outcomes and care-planning components, and refer members to clinical case management or crisis intervention as appropriate.
  • Coordinate and implement assigned care-plan activities and monitor care-plan progress.
  • Consult with case managers, supervisors, Medical Directors, and other health programs using a holistic approach to overcome barriers to goals and objectives, and present cases at case conferences for multidisciplinary review and optimal outcomes.
  • Identify and escalate quality-of-care issues through established channels.
  • Use negotiation skills to secure appropriate options and services that meet members’ benefits and healthcare needs.
  • Use motivational interviewing skills to maximize member engagement and promote lifestyle or behavior changes for optimal health.
  • Provide coaching, information, and support to empower members to make ongoing independent medical and healthy-lifestyle choices.
  • Help members participate actively and knowledgeably with their providers in healthcare decision-making.
  • Use case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Desired Qualifications

  • Case management and discharge planning experience is preferred.
  • Managed care experience is preferred.
  • Long-Term Services and Supports (LTSS) experience is preferred.
  • A bachelor's or master's degree in behavioral health or human services, such as psychology, social work, marriage and family therapy, or counseling, is preferred.
  • Certification in LMHP, RN/LPN, QMHP, LMSW, LBSW, MSW, or BSW is preferred.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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