Case Management Analyst - Field in Harrisonburg, VA

About the Role

This Analyst, Case Management position is with Aetna’s Long-Term Services and Supports (LTSS) team and is a field-based role out of the Harrisonburg, Virginia region. The role requires candidates to travel 70% of the time to meet with members face to face. The Analyst will utilize critical thinking and judgment to collaborate and inform the case management process, facilitating appropriate healthcare outcomes for members by providing care coordination, support, and education.

Responsibilities

• Evaluates members using care management tools and resources, conducts comprehensive assessments of member’s needs/eligibility, and recommends approaches to case resolution or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
• Identifies risk factors and service needs that may impact member outcomes and care planning components, with appropriate referral to clinical case management or crisis intervention as needed.
• Coordinates and implements assigned care plan activities and monitors care plan progress.
• Uses a holistic approach to consult with case managers, supervisors, Medical Directors, and/or other health programs to overcome barriers to meeting goals and objectives.
• Presents cases at case conferences to obtain multidisciplinary review and achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and healthcare needs.
• Employs motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes for optimal health.
• Provides coaching, information, and support to empower members to make independent medical and/or healthy lifestyle choices.
• Helps members actively participate with their providers in healthcare decision-making.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements

• 2 years’ experience in behavioral health, social services, or a related field equivalent to program focus.
• Must reside in Harrisonburg, Virginia, or surrounding areas.
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per company policy.

Preferred Qualifications

• Case management and discharge planning experience.
• Managed Care experience.
• LTSS experience.

Qualifications

• Bachelor's degree or non-licensed master-level clinician required, preferably in behavioral health or human services (psychology, social work, marriage and family therapy, counseling).
• Certification in LMHP, QMHP, LMSW, LBSW, MSW, or BSW preferred.

Pay

The typical pay range for this role is $21.10 - $40.90 per hour. This pay range represents the base hourly rate for all positions in the job grade within which this position falls. The actual base salary offer will depend on factors including experience, education, geography, and other relevant considerations. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.

Anticipated Weekly Hours: 40
Time Type: Full time
Application Window Closes: 11/23/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.