Case Management Analyst

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

A Site of Care Case Management Analyst is a professional who helps organize patient care, working with healthcare providers to ensure that patients receive the infusion services they need in a timely and cost-effective manner.  Case managers must demonstrate a sense of commitment and obligation to maintain current workflow processes, skills, and competencies. Analyzing complex cases and finding resolutions

The Site of Care Case Management will promote a positive working environment and initiate suggestions to continually improve processes and protocols.  Will assist supervisors with standardization of procedures, coaching, training, and dissemination of information to staff.  Act as a subject matter expert in processes and procedures.  Communicate clearly and accurately when interacting with all levels of employees, plan participants, physician offices and support partners.

Manage and support escalated, and advanced SOC issues as needed.  Answer complex questions and recommend corrective action solutions to address complaints/concerns.  Handle special projects and assignments as designated by leadership.

Required Qualifications

- 1 year of Account Management/ Case Management in the Healthcare and/or 1 year of Medical Front office experience

- 3 years Customer Service experience

- Able to apply strong computer skills.  Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable.  Keyboard skills essential.

- Demonstrates strong analytical skills with the ability to evaluate, develop, and deliver alternative courses of action.

Preferred Qualifications

- 1 year of Sales Force experience

- 1 year of previous sales experience

- Must be able to multitask and utilize multiple system applications simultaneously.

- Diffuses issues and complaints by physicians and members and solves escalated problems while maintaining a calm and professional attitude in emotionally charged interactions.

Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.

- Must be able to utilize available resources independently and provide high quality work.

- Must be able to absorb presented information, display motivation, seek development and problem solve.

- Ability to adapt and change with workflow and shifting priorities.

- Must possess excellent written, verbal, grammar, and listening communication skills.

- Must be able to deal with a diverse customer base (internal and external) in a friendly and confident manner.

- Ability to maintain confidentiality of PHI (Protected Healthcare Information).

- Seeks ways to collaborate and reach consensus with peers; actively works to build strong working relationships; Able to customize messages and deliver to broader audiences; Demonstrates troubleshooting, problem-solving ability, and attention to detail. Demonstrates sense of urgency with assignments.

- Demonstrates leadership skills and professional maturity.  Creates a cohesive team atmosphere.  Embraces change positively.

- Bachelors or Masters Degree

- Must have ability to quickly learn new computer applications.  Must have foundation of adjudication platforms and processes.  Must be able to create and maintain reports and data collection.

Education

High School Diploma or Equivalent GED

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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.

For more information, visit 

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