Full-Time

Case Management Analyst

Field Based, Northwest, OH

Posted on 9/20/2024

CVS Pharmacy

CVS Pharmacy

10,001+ employees

Retail pharmacy and healthcare services provider

Healthcare
Consumer Goods

Compensation Overview

$21.1 - $36.78Hourly

+ Bonus + Commission + Short-term Incentive Program

Entry, Junior

Company Historically Provides H1B Sponsorship

Ohio, USA

Must be able to travel within Fulton, Lucas, Ottawa, Wood counties in Ohio.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
Word/Pages/Docs
PowerPoint/Keynote/Slides
Requirements
  • Must be able to travel within the following Ohio counties: Fulton, Lucas, Ottawa, Wood.
  • 2 years’ LPN experience or in behavioral or physical health, social services, or appropriate related field equivalent to program focus
  • Ability to travel up to 75% within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
  • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
  • Excellent analytical and problem-solving skills.
  • Effective communications, organizational, and interpersonal skills.
  • Ability to work independently to meet productivity requirements.
  • Ability to positively adapt and implement frequent process changes.
  • Efficient and Effective computer skills including navigating multiple systems and keyboarding.
  • LPN or bachelor’s degree in behavioral health or health care related field (psychology, social work, counseling, nutrition, PT or OT Assistant etc.)
Responsibilities
  • Using care management tools and information/data review, conducts ongoing face to face and telephonic outreach to locate and engage unreached members.
  • Identifies and coordinates members’ initial nonclinical service needs (DME, transportation, etc.) in coordination with a Transdisciplinary Care Team (TDC).
  • 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.
  • Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
  • Utilizes case management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their pharmacies offer prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also includes a pharmacy benefits manager that serves over 75 million plan members and a senior pharmacy care business that assists more than one million patients each year. This integrated model allows CVS Health to deliver affordable health management solutions, improving access to quality care and health outcomes while aiming to reduce overall healthcare costs. Unlike many competitors, CVS Health combines retail pharmacy services with clinical care and pharmacy benefits management, making it a significant player in the healthcare sector with a goal of supporting individuals on their journey to better health.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

Growth & Insights
Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
Simplify Jobs

Simplify's Take

What believers are saying

  • Expansion of at-home health testing kits presents a significant growth opportunity for CVS.
  • Maintaining free cash-back services could differentiate CVS from other retailers.
  • Growing market for accessible hearing solutions offers CVS a chance to expand product offerings.

What critics are saying

  • At-home health tests may reduce in-store visits, impacting CVS's foot traffic.
  • Fees for cash-back transactions could lead to customer dissatisfaction if adopted by CVS.
  • Increased competition in OTC hearing aids may challenge CVS's market share.

What makes CVS Pharmacy unique

  • CVS offers a comprehensive range of health services and products under one roof.
  • The company has a strong pharmacy benefits management with over 75 million plan members.
  • CVS's extensive retail network includes 9,600 pharmacies and 1,100 walk-in clinics.

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