Case Management Analyst

CVS Health

. Evaluate referred members’ needs and eligibility using care management tools and information/data review .

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

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management processes, including evaluating member needs, coordinating care plans, and ensuring compliance with regulatory standards. Proficient in using motivational interviewing techniques to engage members in their healthcare decisions and lifestyle changes.

Highest-signal resume keywords

Case Management ExperienceMotivational InterviewingMicrosoft Office 365Managed Care ExperienceMultilingual Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Management ToolsQuality Management ProcessesDischarge PlanningElectronic Health Record ExperienceData ReviewHigh-Risk Factor IdentificationCrisis InterventionMember Engagement TechniquesHealthcare Decision SupportTechnical Issue Resolution

Soft Skills

Communication SkillsCoaching SkillsNegotiation SkillsProblem-Solving SkillsTeam Collaboration

Tools & Technologies

Microsoft OfficeEHR PortalsVPNTeams MessagingGoogle Workspace

Industry Keywords

Healthcare ComplianceHIPAA GuidelinesManaged CareHuman Services FieldQuality of Care Issues

About the role

Key responsibilities & impact

Evaluate referred members’ needs and eligibility using care management tools and information/data review
Recommend case resolution approaches and identify available programs and services
Identify high-risk factors and service needs, with appropriate referrals to clinical case management or crisis intervention
Coordinate and implement care plan activities and monitor progress
Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
Present cases at multidisciplinary case conferences
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 and influencing skills to promote member engagement and lifestyle changes
Coach, inform, and support members in making 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
Manage a full caseload of waiver members
Conduct in-person quarterly member visits and travel to meet members face to face

Requirements

What you’ll need

Must reside in Illinois in Lake or DuPage County
Valid Illinois driver’s license
Reliable transportation
Willing and able to travel up to 75% of the time
Minimum of two (2) years of case management experience
Microsoft Office and electronic health record experience
Bachelor’s degree or a non-licensed individual with a master’s degree, with either degree in a human-services field
Discharge planning experience preferred
Managed Care experience preferred
Multilingual language proficiency preferred
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum download speed of 25 Mbps and upload speed of 3 Mbps
Wi-Fi and satellite internet are not permitted
Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Must provide own workspace furniture
Ability to set up and use multiple monitors and navigate multiple applications
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar Google Workspace applications
Ability to log in to secure systems such as VPN and EHR portals, secure computer screens, manage strong passwords, and recognize suspicious emails or links
Ability to resolve common technical issues independently
Openness to learning new skills as the workplace evolves

Benefits

Comp & perks

Mileage is reimbursed per company expense reimbursement policy
Company-provided equipment (keyboard, monitor, computer, headset, etc.)
Medical, dental, and 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