Analyst, Case Management

CVS Health

Case Management Coordinator utilizing critical thinking to assist with healthcare outcomes at CVS Health. Monitoring care plans and collaborating with providers for optimal member engagement.

Posted 5/6/2026full-timeSpringfield • Illinois • 🇺🇸 United StatesJuniorMid-Level💰 $21 - $45 per hourWebsite

About the role

Key responsibilities & impact

The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process
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
Conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services
Identifies 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 appropriate
Coordinates and implements assigned care plan activities and monitors care plan progress
Consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes
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
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
Helps member actively and knowledgably participate with their provider in healthcare decision-making
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

What you’ll need

2 years experience in behavioral health, social services or appropriate related field equivalent to program focus
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently in an autonomous environment; self starter
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Efficient and Effective computer skills including navigating multiple systems and keyboarding
Must possess reliable transportation and be willing and able to travel up to 10% of the time. Mileage is reimbursed per our company expense reimbursement policy.

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

case managementbehavioral healthsocial servicesanalytical skillsproblem-solving skillsnegotiation skillsmotivational interviewingquality management processescompliance with regulatory guidelinesappointment scheduling

Soft Skills

critical thinkingjudgmenteffective communicationorganizational skillsinterpersonal skillsindependent thinkerself-startermember engagementcoachingempowerment