Case Management Analyst – Field

CVS Health

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

Posted 11/12/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $21 - $45 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in care coordination and case management, with a strong focus on behavioral health and social services. Proficient in evaluating member needs, implementing care plans, and ensuring compliance with regulatory standards.

Highest-signal resume keywords

Case Management ExperienceBehavioral Health ExpertiseCare Coordination SkillsMotivational InterviewingDischarge Planning Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Management ToolsData ReviewQuality Management ProcessesBenefit Plan EvaluationCrisis InterventionComprehensive EvaluationsMonitoring ProgressNegotiation SkillsCoaching SkillsHealthcare Decision-Making Support

Soft Skills

Influencing SkillsCommunication SkillsEmpathyProblem-SolvingTeam Collaboration

Tools & Technologies

Microsoft Office

Industry Keywords

Managed CareSocial ServicesHuman ServicesRegulatory ComplianceAccreditation Standards

About the role

Key responsibilities & impact

Facilitate appropriate healthcare outcomes for members through care coordination, support and education
Conduct comprehensive evaluations of referred members' needs and eligibility using care management tools and data review
Evaluate benefit plans and internal and external programs/services to recommend case-resolution approaches
Identify high-risk factors and service needs, with referral 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 influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes
Provide coaching, information and support to empower 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

Must reside in St Clair County IL or Surrounding Areas
Willing and able to travel 50-75% of the time to meet members face to face
Minimum 2 years of experience in behavioral health, social services or human services field
Minimum 2 years of case Management experience
Discharge Planning experience preferred
Managed Care experience preferred
Microsoft Office experience preferred
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (psychology, social work, marriage and family therapy, counseling)

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