# Analyst, Case Management Field

**Company**: CVS Health
**Location**: Springfield, IL
**Work arrangement**: hybrid
**Experience**: mid
**Job type**: full-time
**Salary**: $21.10 - $44.99
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/IL---Springfield/Case-Management-Coordinator---Field-in-Sangamon-County-Illinois_R1096923-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/analyst-case-management-field-2dcf223e-63b/

## Description

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

This Analyst, Case Management Field position is with Aetna's Waiver team and is a field-based position out of the Sangamon County area of Illinois. The requirements are for candidates to travel 50-75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in-person quarterly visits with members.

**Evaluation of Members:** Through the use of care management tools and information/data review, you will conduct comprehensive evaluations of referred members' needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating members' benefit plans and available internal aid and external programs/services.

- Identify high-risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as needed.

- Coordinate and implement assigned care plan activities and monitor care plan progress.

**Enhancement of Medical Appropriateness and Quality of Care:** Using a holistic approach, you will consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.

- Identify and escalate quality of care issues through established channels.

- Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.

- Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.

- Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

- Help members actively and knowledgeably participate with their provider in healthcare decision-making.

**Monitoring, Evaluation and Documentation of Care:** You will utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

**Required Qualifications:**

- Reside in the state of Illinois in the Sangamon County IL Area

- Valid Illinois Driver's license

- Willing and able to travel up to 75% of your time to meet with members face to face

- Reliable Transportation required, eligible for mileage reimbursement as per company policy.

- Minimum of two (2) years of case management experience

- Microsoft Office and electronic health record experience

**Preferred Qualifications:**

- Case management and discharge planning experience

- Managed Care experience

- Microsoft Office experience

**Education:**

- Individual with a bachelor's degree or a non-licensed individual with a master's degree, with either degree being in a human-services field (including, but not limited to social work, psychology)

**Anticipated Weekly Hours:** 40

**Time Type:** Full-time

**Pay Range:** $21.10 - $44.99

**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.

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## Skills

### Required
- case management
- Microsoft Office
- electronic health record
- Illinois Driver's license

### Nice to have
- discharge planning
- Managed Care

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/IL---Springfield/Case-Management-Coordinator---Field-in-Sangamon-County-Illinois_R1096923-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)