Analyst, Case Management

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Analyst, Case Management Field conducts routine care coordination, support, and education for members through the use of care management resources to facilitate appropriate healthcare outcomes. This role applies case management principles to assess member needs, address barriers to care, connect members with appropriate resources, and empower individuals to make informed healthcare decisions. The position requires strong communication, motivational interviewing, documentation, and organizational skills while maintaining compliance with regulatory and organizational standards. A Brief Overview The Analyst, Case Management is responsible for coordinating care and supporting members through assessment, education, advocacy, and resource navigation. Working collaboratively with healthcare providers, care teams, and community partners, this individual helps members achieve optimal health outcomes by addressing healthcare needs, promoting self-management, and facilitating access to appropriate services and benefits. Success in this role requires excellent customer service, problem-solving abilities, and the ability to build rapport and trust telephonically. What You Will Do • Conduct comprehensive assessments to evaluate member needs, eligibility, barriers to care, and opportunities for intervention. • Provide routine care coordination, support, and education to members to improve health outcomes. • Utilize motivational interviewing techniques to increase member engagement and promote healthy lifestyle changes. • Empower members to make informed healthcare decisions and actively participate in their care plans. • Collaborate with case managers, supervisors, medical directors, providers, and other healthcare professionals to address member needs. • Present cases at interdisciplinary case conferences to support optimal member outcomes. • Identify and escalate quality of care concerns through established channels. • Assist members in accessing appropriate services, benefits, and community resources. • Demonstrate effective negotiation skills to secure services and support necessary to meet member needs. • Maintain accurate, timely, and compliant documentation of all case management activities. • Meet productivity, quality, and performance metrics while managing a diverse caseload. • Support implementation of case management programs, projects, policies, and processes. • Utilize technology and multiple systems effectively to support member care and documentation requirements. • Manage workload independently while maintaining organizational priorities and deadlines. Required Qualifications • Minimum of two (2) years of experience in case management, behavioral health, social services, healthcare, or a related field. • Experience working with adult and/or adolescent populations. • Strong customer service orientation with excellent problem-solving skills. • Excellent verbal, written, and telephonic communication skills. • Demonstrated motivational interviewing skills and ability to establish rapport and trust telephonically. • Strong attention to detail with exceptional documentation skills. • Commitment to compliance, regulatory requirements, and quality standards. • Highly organized and self-motivated with the ability to work independently with minimal supervis