Analyst, Case Management – Field – Must reside in Northern Chicago Illinois

Analyst, Case Management – Field – Must reside in Northern Chicago Illinois

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. This is a field-based position requiring travel to meet with members face to face in the northside of Chicago, IL and surrounding areas.

Position Summary

This is a field-based position with expected travel of 50-75% to meet with members face to face on the northside of Chicago, IL and surrounding areas. Strongly prefers candidates to reside on the Northside Chicago area. Schedule is Monday-Friday, standard business hours, 8 : 00am-4 : 30pm CST. Analys t Case Manager is responsible for telephonically and / or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

Responsibilities

• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.
• Through the use of clinical tools and information / data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member’s level of work capacity and related restrictions / limitations.
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications

Preferred Qualifications

Education

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is $21.10 - $44.99

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

For more information, visit the CVS Health benefits page. We anticipate the application window for this opening will close on : 10 / 09 / 2025

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

Senioriry level

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