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CVS Health

Runs pharmacies, health plans and clinics

Analyst – Case Management

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • A degree in a Health Care or Human Services related field is required.
  • Case Management experience is required.
  • Strong customer service orientation and problem-solving skills are required.
  • Excellent communication and telephonic skills are required.
  • Excellent motivational interviewing skills and the ability to build rapport and trust telephonically are required.
  • Excellence in documentation and adherence to compliance and regulatory standards are required.
  • Ability to remain highly organized and self-driven without direct supervision is required.
  • Ability to manage time effectively and achieve performance metrics is required.
  • Technology proficiency is required.
  • Ability to travel within 125 miles round trip for one day in the field is required.
  • Ability to work a variable schedule, including two days weekly until 9 p.m. local time, is required.
  • Must live in Louisiana Region 7: Northwest parishes of Caddo, Bossier, Webster, Claiborne, Bienville, Red River, DeSoto, Sabine, or Natchitoches.

Responsibilities

  • Consult with case managers, supervisors, medical directors, and/or other health programs using a holistic approach to overcome barriers to meeting goals and objectives.
  • Present cases at case conferences to obtain a multidisciplinary review and achieve optimal outcomes.
  • Identify and escalate quality-of-care issues through established channels.
  • Use negotiation skills to secure appropriate options and services needed to meet members’ benefits and healthcare needs.
  • Use influencing and motivational interviewing skills to promote member engagement and lifestyle or behavior changes to achieve optimal health.
  • Provide coaching, information, and support to empower members to make ongoing independent medical and healthy lifestyle choices.
  • Encourage members to actively participate with their providers in healthcare decision-making.
  • Conduct comprehensive evaluations of referred members’ needs and eligibility using care management tools, and recommend an approach to case resolution.
  • Conduct routine care coordination, support, and education using care management resources to facilitate appropriate healthcare outcomes.
  • Help implement Case Management projects, programs, and processes, and apply practical Case Management knowledge to administer policies, procedures, and plans.

Desired Qualifications

  • A Bachelor's and/or Master's degree is preferred.
  • CCM certification is preferred.
  • Previous experience in a managed care organization 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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