Analyst, Case Management Field
Core
Facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education using care management tools.
Role type
Case Management Analyst
Builds
Care plans and member engagement strategies
Domain
Health insurance / Behavioral health
Required skills
Critical thinking, Care coordination, Benefit plan evaluation, Risk factor identification, Care plan monitoring, Negotiation, Motivational interviewing, Coaching
Preferred skills
Case management and discharge planning experience, Managed Care experience
Technologies
Care management tools
Responsibilities
Collaborate to inform the case management process, Evaluate members' needs and eligibility, Identify risk factors and service needs, Coordinate and implement assigned care plan activities, Consult with case managers and Medical Directors to overcome barriers, Escalate quality of care issues, Provide coaching to empower members for independent medical choices.
Seniority
Mid-level, hands-on IC