Analyst, Case Management

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

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. This role applies case management principles to assess member needs, address barriers to care, connect members with appropriate resources, and empower individuals to make informed healthcare decisions. The position requires strong communication, motivational interviewing, documentation, and organizational skills while maintaining compliance with regulatory and organizational standards.

A Brief Overview

The Analyst, Case Management is responsible for coordinating care and supporting members through assessment, education, advocacy, and resource navigation. Working collaboratively with healthcare providers, care teams, and community partners, this individual helps members achieve optimal health outcomes by addressing healthcare needs, promoting self-management, and facilitating access to appropriate services and benefits. Success in this role requires excellent customer service, problem-solving abilities, and the ability to build rapport and trust telephonically.

What You Will Do

• 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 organizational priorities and deadlines.

Required Qualifications

• Minimum of two (2) years of experience in case management, behavioral 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 organized 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.

Preferred Qualifications

• Medicaid experience.
• Waiver program experience.
• Managed Care Organization (MCO) experience.
• Certified Case Manager (CCM) certification.
• Master's degree in a healthcare, social services, or related field.
• Crisis intervention experience and skills.
• Utilization review experience.
• Case management and discharge planning experience.
• Experience with QuickBase or similar case management platforms.
• Proficiency with Microsoft Teams, Outlook, Word, Excel, and SharePoint.
• Previous experience coordinating care for complex populations.

Education Required:

• Bachelor's Degree in Healthcare, Human Services, Social Work, Psychology, Sociology, Public Health, or a related field.

Preferred:

• Master's Degree in a healthcare or human services-related field.
• Certified Case Manager (CCM) Certification.
• Previous Experience in Managed Care Organization

Anticipated Weekly Hours

40 Hours per Week

Variable work schedule with the ability to work two evenings per week until 9:00 PM local time.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.