Analyst, Case Management – Field

CVS Health

. Conduct comprehensive evaluations of referred members’ needs and eligibility using care management tools and data review .

Posted 10/15/2026full-timeUnited StatesJuniorMid-Level💰 $21 - $37 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management and quality management processes, ensuring compliance with regulatory and accreditation standards. Proficient in using care management tools and data analysis to evaluate member needs and coordinate care plans effectively.

Highest-signal resume keywords

Case ManagementBehavioral Health ExperienceMotivational InterviewingMS Office Suite ProficiencyRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementData ReviewBenefit Plan EvaluationQuality Management ProcessesMotivational InterviewingMulti-System NavigationTechnical Issue ResolutionEHR Portal ManagementInternet Speed ComplianceVirtual Meeting Coordination

Soft Skills

Member EngagementCoachingCommunicationProblem-SolvingCollaboration

Tools & Technologies

MS Office SuiteMicrosoft Office 365Google WorkspaceVPNSecure Systems

Industry Keywords

Behavioral HealthSocial ServicesHIPAA ComplianceAccreditation StandardsHealthcare Decision-Making

About the role

Key responsibilities & impact

Conduct comprehensive evaluations of referred members’ needs and eligibility using care management tools and data review
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 as 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 through established channels
Negotiate appropriate options and services to meet members’ benefits and healthcare needs
Use motivational interviewing to promote member engagement and lifestyle or behavior changes
Provide coaching, information, and support for independent medical and healthy lifestyle choices
Help members participate knowledgeably in healthcare decisions with providers
Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements
Travel to member homes, residential treatment facilities, group homes, shelters, and detention facilities in Northern West Virginia

Requirements

What you’ll need

2 years’ experience in behavioral health, social services, or an appropriate related field equivalent to program focus
West Virginia resident residing in Barbour, Brooke, Doddridge, Hancock, Harrison, Lewis, Marion, Marshall, Monongalia, Ohio, Pleasants, Ritchie, Taylor, Tyler, Upshur, or Wetzel County
Reliable transportation and willingness and ability to travel in the assigned region 50% or more of the time
2+ years of experience with personal computer, keyboard, mouse, multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)
Bachelor’s degree or non-licensed master level clinician required
Degree in behavioral health or human services preferred, including psychology, social work, marriage and family therapy, or counseling
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently residing
Must obtain required internet speeds and adhere to Work From Home requirements
Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace tools
Ability to log in to secure systems such as VPN and EHR portals, secure devices, manage strong passwords, and recognize suspicious emails or links
Ability to resolve common technical issues independently and contact IT when needed
Openness to learning new skills as the workplace evolves

Benefits

Comp & perks

Mileage is reimbursed per company expense reimbursement policy
No nights, no weekends, and no holidays
Company-provided equipment (keyboard, monitor, computer, headset, etc.)
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being