Case Management Analyst

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.

This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

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

Pay Range

The typical pay range for this role is :

$19.52 - $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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.