Case Management Analyst

CVS Health

. Collaborate and inform the case management process to facilitate appropriate healthcare outcomes for members .

Posted 11/4/2026full-timeRichmond • Virginia • United StatesJuniorMid-Level💰 $21 - $41 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care coordination, case management, and behavioral health, with a strong focus on member engagement and compliance with regulatory standards. Proficient in evaluating member needs and facilitating healthcare outcomes through effective communication and collaboration.

Highest-signal resume keywords

Case Management ExperienceBehavioral Health KnowledgeMotivational InterviewingCare CoordinationManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Management ToolsBenefit Plan EvaluationCrisis InterventionQuality Management ProcessesDischarge Planning

Soft Skills

CollaborationCoachingNegotiationCommunicationProblem-Solving

Certifications & Qualifications

Bachelor's DegreeMaster's Degree in Behavioral Health or Human Services

Industry Keywords

Healthcare OutcomesCase ConferencesRisk FactorsMember EngagementRegulatory Compliance

About the role

Key responsibilities & impact

Collaborate and inform the case management process to facilitate appropriate healthcare outcomes for members
Provide care coordination, support, and education using care management tools and resources
Evaluate members’ needs and eligibility and recommend case resolution approaches
Evaluate benefit plans and available internal and external programs/services
Identify risk factors and service needs and refer to clinical case management or crisis intervention as appropriate
Coordinate assigned care plan activities and monitor care plan 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/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

Requirements

What you’ll need

2 years’ experience in behavioral health, social services or an appropriate related field equivalent to program focus
Must reside in Central Virginia Area
Up to 70% travel required in Central region Virginia
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
Case management and discharge planning experience preferred
Managed Care experience preferred

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program eligibility