Case Management Analyst, CVS Health

CVS Health

Location:
United States, Frankfort

Category:
-

Contract Type:
Employment contract

Salary:

21.10 - 36.78 USD / Hour

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Job Description:

Aetna Better Health is hiring for multiple openings across the state/regions of Kentucky. Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, in order to facilitate and maintain improved healthcare outcomes for members by providing advocacy, collaboration coordination, support and education for members through the use of care management tools and resources.

Job Responsibility:

Utilizes critical thinking and professional judgment to support the case management process
Facilitates and maintains improved healthcare outcomes for members by providing advocacy, collaboration coordination, support and education
Evaluates member’s benefit plan and available internal and external programs/services
Identifies high risk factors and service needs
Coordinates and implements Wellness care plan activities and monitors member care needs
Consults with case managers, supervisors, Medical Directors and/or other health programs
Identifies and escalates quality of care issues
Utilizes negotiation skills to secure appropriate options and services
Provides coaching, information and support to empower the member
Helps member actively and knowledgably participate with their provider in healthcare decision-making
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Requirements:

Minimum 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY populations
3+ years' experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling
1+ MCO experience
Minimum of a Bachelor's degree or a non-licensed master level clinician in behavioral health or human services field

Nice to have:

3+ years' experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling
1+ MCO experience

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
March 29, 2025

Expiration:
April 30, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Case Management Analyst