Analyst, Case Management

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Program Overview

Aetna’s Corporate Care Management is expanding our Engagement Hub services. The Engagement Hubs are focused on driving member engagement into Aetna’s Care Management programs, while also delivering care services to members who do not need long term support but have immediate care needs. This is an exciting time to join Aetna, a CVS Health Company, in our journey to change the way healthcare is delivered today. We are health care innovators who provide a human connection when it is needed most.

Position Summary

The Information and Referral Specialist provides information, referrals, assistance with accessing resources, health coaching, and supportive care to members. The I&R Specialist will support multiple member service initiatives by assessing the member’s stated and unstated needs, addressing resource needs, and effectively utilizing community, health care, and plan benefit resources. Hours will be between 11:30am - 8:00pm EST

Fundamental Components

• Utilize designated interactions to assess the member’s stated and unstated needs, including social determinants of health
• Accurately and thoroughly documents each call in the member’s electronic record, thoroughly completing required actions with a high level of detail to ensure Compliance and Regulatory Standards are met
• Secure resources to address the member’s needs, including connection to community and national resources
• Accurately assess the need for clinical (Nurse RN or Social Worker) intervention and work closely with Engagement Hub Clinical Consultants to serve our members
• Educate members on available services and empower participation
• Assist the member in actively participating with their health care providers and Aetna Care Management teams regarding decisions that impact their health and well-being
• Troubleshoot unavailability of resources, securing support as needed to close member gaps
• Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
• Assist members in problem-solving when no services are available which can meet their needs
• Demonstrates an ability to be agile and adapt to change with enthusiasm
• Possess top-notch people skills – listening, caring, connecting, empathizing, and supporting
• Ability to seamlessly multi-task while using multiple systems to efficiently provide service to members

Required Qualifications

• At least 2 years working within the healthcare, nonprofit, or community-based services industry
• Exhibits strong desire and commitment to serving others
• Candidates with experience in information & referral, health coaching, care management, social work, aging network, strongly preferred
• Comprehensive working knowledge of services available within one’s community and across our nation strongly preferred
• Community health or public health experience preferred
• Managed Care/Medicare/Medicaid experience preferred
• Bilingual (Spanish) preferred
• Flexibility with work schedule to meet business needs

Education and Certification Requirements

• Bachelor’s degree or equivalent work experience

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.