Analyst, Case Management

CVS Health

. Facilitate appropriate healthcare outcomes for waiver/LTSS members through care coordination, support, and education .

Posted 9/16/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $21 - $45 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination and case management, with a focus on member engagement and quality improvement. Proficient in evaluating healthcare needs, implementing care plans, and navigating regulatory requirements.

Highest-signal resume keywords

Case Management ExperienceCare CoordinationMotivational Interviewing SkillsManaged Care ExperienceBachelor's Degree in Human Services

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementDischarge PlanningQuality Management ProcessesComprehensive EvaluationsBenefit Plan EvaluationCrisis InterventionHealthcare Decision-MakingElectronic Health Record ExperienceMicrosoft OfficeTravel Coordination

Soft Skills

Influencing SkillsCoachingCommunicationProblem-SolvingTeam Collaboration

Industry Keywords

HIV/AIDS HCBS WaiverRacial and Ethnic MinoritiesLGBTQ+ CommunitySubstance Use DisordersHealthcare OutcomesQuality of Care IssuesRegulatory ComplianceAccreditation StandardsMember EngagementHigh-Risk Factors

About the role

Key responsibilities & impact

Facilitate appropriate healthcare outcomes for waiver/LTSS members through care coordination, support, and education
Conduct comprehensive evaluations of referred members’ needs and eligibility
Recommend case-resolution approaches by evaluating benefit plans and internal and external programs/services
Identify high-risk factors and service needs affecting member outcomes and care planning
Refer members to clinical case management or crisis intervention when appropriate
Coordinate and implement assigned care-plan activities and monitor progress
Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
Present cases at case conferences for multidisciplinary review
Identify and escalate quality-of-care issues
Negotiate appropriate options and services to meet members’ benefit and healthcare needs
Use influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes
Provide coaching, information, and support for independent medical and healthy-lifestyle choices
Help members participate knowledgeably in healthcare decision-making with providers
Apply case-management and quality-management processes in compliance with regulatory, accreditation, and company requirements
Travel 50–75% and conduct in-person quarterly member visits

Requirements

What you’ll need

Must reside in the state of Illinois in Rock Island area
Valid Illinois Driver’s license
Willing and able to travel up to 75% of their time to meet with members face to face
Reliable Transportation required
Minimum of two (2) years of case management experience
Microsoft Office and electronic health record experience
If managing HIV/AIDS HCBS Waiver members: experience working with racial and ethnic minorities and one or more of domestic abuse, the LGBTQ+ community, persons living with HIV/AIDS, or persons with substance use disorders
Case management and discharge planning experience preferred
Managed Care experience preferred
Bachelor’s degree or non-licensed master’s degree in a human-services field, including sociology, special education, or rehabilitation counseling

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay range
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being, based on eligibility
Mileage reimbursement as per company policy