Case Management Analyst

CVS Health

. Assess, plan, implement, and coordinate case management activities telephonically and face to face .

Posted 11/5/2026full-timeNaperville • Illinois • United StatesJuniorMid-Level💰 $21 - $45 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management activities, including assessment, planning, and implementation of care strategies to enhance member wellness. Proficient in evaluating medical needs and facilitating transitions to appropriate programs while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Case Management ExperienceClinical JudgmentBehavioral Health KnowledgeHolistic Assessment SkillsBachelor's Degree in Related Field

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentData ReviewRisk Factor ReductionMS Office SuiteBehavioral HealthLong Term CareMember EngagementEligibility EvaluationTransportation Management

Soft Skills

CommunicationCollaborationProblem-SolvingInterpersonal SkillsAdaptability

Industry Keywords

Integrated ModelNursing Home SettingRegulatory ComplianceMultidisciplinary Case ConferencesHealth and Social Indicators

About the role

Key responsibilities & impact

Assess, plan, implement, and coordinate case management activities telephonically and face to face
Evaluate members’ medical needs to facilitate overall wellness
Develop proactive courses of action to address issues and improve short- and long-term outcomes
Use clinical tools and information/data review to evaluate member needs and benefit plan eligibility
Facilitate transitions to Aetna programs and plans
Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators
Conduct holistic assessments covering co-morbid and multiple diagnoses affecting functionality
Review prior claims for potential impact on current case management and eligibility
Assess work capacity and related restrictions or limitations
Refer members to clinical resources when needed
Consult with supervisors and colleagues to overcome barriers and meet goals
Present cases at multidisciplinary case conferences
Use case management processes in compliance with regulatory and company policies
Conduct interviews to maximize member engagement and determine health status and needs
Travel to meet members face to face in Chicago and surrounding areas

Requirements

What you’ll need

Must reside in DuPage County or Western Cook County IL or Surrounding Areas
Minimum 2 years of Case Management practice experience required
Minimum 1 year experience in MS Office Suite applications
Willing and able to travel 50-75% of their time using their own vehicle
Reliable transportation required
Case Management in an integrated model preferred
Experience working with adults with Behavioral Health needs preferred
Long Term care experience in Nursing Home setting preferred
Bachelor’s Degree required, preferably in social work, psychology, nursing, human services, or related field
Non-licensed Master’s degree preferred
Schedule is Monday-Friday, standard business hours, 8:00am-4:30pm CST

Benefits

Comp & perks

Mileage is reimbursed per our company expense reimbursement policy
CVS Health bonus, commission or short-term incentive program in addition to the base pay range
Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting colleagues’ physical, emotional, and financial well-being