[Hiring] Analyst, Case Management – Transition of Care (Care Coordinator) @CVS Health

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Case Management Coordinator (i.e. CC) utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. • Evaluation of Members: Conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution. • Identifies high risk factors and service needs that may impact member outcomes and care planning components. • Coordinates and implements assigned care plan activities and monitors care plan progress. • Enhancement of Medical Appropriateness and Quality of Care: Consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives. • 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. • Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. • Helps member actively and knowledgeably participate with their provider in healthcare decision-making. • Monitoring, evaluation and documentation of care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Remote Work Expectations • This is a remote role; candidates must have a dedicated workspace free of interruptions. • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Qualifications • 2+ years experience in behavioral health or social services • Candidate must have the ability to work 8:00 AM - 5:00 PM in assigned market time zone • 2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook) • Candidates must have a dedicated workspace free of interruptions • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted Preferred Qualifications • Case management and discharge planning experience • Managed care experience Education • Bachelor's Degree or non-licensed master level clinician with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) or equivalent experience Anticipated Weekly Hours • 40 Time Type • Full time Pay Range The typical pay range for this role is: $21.10 - $36.78. 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. Benefits • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Application Information We anticipate the application window for this opening will close on: 04/05/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job Apply To this Job