Analyst, Case Management Field

We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.

The Analyst, Case Management Field conducts routine care coordination, support, and education for members through the use of care management resources to facilitate appropriate healthcare outcomes.

Responsibilities

• Conduct comprehensive assessments to evaluate member needs, eligibility, barriers to care, and opportunities for intervention.
• Provide routine care coordination, support, and education to members to improve health outcomes.
• Utilize motivational interviewing techniques to increase member engagement and promote healthy lifestyle changes.
• Empower members to make informed healthcare decisions and actively participate in their care plans.
• Collaborate with case managers, supervisors, medical directors, providers, and other healthcare professionals to address member needs.
• Present cases at interdisciplinary case conferences to support optimal member outcomes.
• Identify and escalate quality of care concerns through established channels.
• Assist members in accessing appropriate services, benefits, and community resources.
• Demonstrate effective negotiation skills to secure services and support necessary to meet member needs.
• Maintain accurate, timely, and compliant documentation of all case management activities.
• Meet productivity, quality, and performance metrics while managing a diverse caseload.
• Support implementation of case management programs, projects, policies, and processes.
• Utilize technology and multiple systems effectively to support member care and documentation requirements.
• Manage workload independently while maintaining organisational priorities and deadlines.

Required Qualifications

• Minimum of two (2) years of experience in case management, behavioural health, social services, healthcare, or a related field.
• Experience working with adult and/or adolescent populations.
• Strong customer service orientation with excellent problem-solving skills.
• Excellent verbal, written, and telephonic communication skills.
• Demonstrated motivational interviewing skills and ability to establish rapport and trust telephonically.
• Strong attention to detail with exceptional documentation skills.
• Commitment to compliance, regulatory requirements, and quality standards.
• Highly organised and self-motivated with the ability to work independently with minimal supervision.
• Strong time management and multitasking abilities.
• Proficiency with computers and technology platforms used for case management and documentation.
• Ability to interface effectively with members, providers, and internal stakeholders.
• Ability to work a variable schedule, including two evenings per week until 9:00 PM local time.
• Ability to meet established performance and productivity metrics.

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.