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CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Analyst, Case Management – Transition of Care (Care Coordinator)
Location
United States + 1 moreAll locations: United States | Canada
Posted
106 days ago
Salary
$21 - $37 / hour
No structured requirement data.
Job Description
Analyst, Case Management – Transition of Care (Care Coordinator)
CVS Health
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 Case Management Coordinator (i.e. CC) utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. Fundamental Components - Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. - Identifies high 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 appropriate. - Coordinates and implements assigned care plan activities and monitors care plan progress. - Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach, consults 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 in order to 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/or healthcare needs. - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. - Provides coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. - Helps member actively and knowledgeably participate with their provider in healthcare decision-making. - Monitoring, evaluation and documentation of care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Remote Work Expectations - This a remote role, candidates must have a dedicated workspace free of interruptions. - Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Required Qualifications - 2+ years experience in behavioral health or social services - Candidate must have the ability to work 8:00 AM - 5:00 PM in assigned market time zone - 2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook) - Candidates must have a dedicated workspace free of interruptions - Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted Preferred Qualifications - Case management and discharge planning experience - Managed care experience Education - Bachelor's Degree or non-licensed master level clinician with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) or equivalent experience Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10 - $36.78 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/05/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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We embrace passionate Team Members who consistently display our values: United, Informative, Approachable, Caring and Transparent. We are united in our collective effort to achieve member goals and proactively provide solutions tailored to individual Member needs. We are committed to ensuring that each Member receives a positive service experience and trusted financial advice. Join the Nuvision Team today! Let us be part of your career journey! The purpose of this position is to enhance the safety and security of the credit union assets by executing the credit union’s fraud prevention program. The position will be responsible for monitoring suspicious transactions across multiple channels and taking necessary steps to prevent or mitigate losses. The Sr. Fraud Review Specialist will also monitor incoming fraud and queues and provide support to the charge back process. The Sr. Fraud Review Specialist will have a strong background in VISA debit and credit card fraud monitoring and will be able coordinate complex investigations for referral to law enforcement. The Sr. Fraud Review Specialist adds value to the Credit Union by ensuring that risk and exposures are managed to the benefit of the membership. Responsibilities: - Review escalated fraud alerts from the credit and debit card portfolio for risk decisions. - Analyze and update rules and alerts for optimal effectiveness. - Review the incoming fraud and dispute queues for trends and assignments. - Coordinate complex investigations, create case narratives for suspicious transactions for referral to BSA group and direct referral to law enforcement. - Create lessons learned memorandums and administer roundtables and committees to analyze loss situations to prevent re-occurrences. - Maintains a high degree of knowledge related to VISA debit and credit card products, fraud prevention and investigations. - Treats all co-workers and members with respect. - Supports and participates in continuous improvement activities. - Represents the Credit Union in a positive and professional manner. - Maintains member and other sensitive information with confidentiality. - Other related duties as assigned. Minimum Qualifications: - 3 years expertise in financial analysis with an emphasis on fraud detection. - Understanding of banking and fraud threats. Must be familiar with plastic card fraud alert rules and be able to make risk-based adjustments. - Computer modeling and data mining skills, analytical skills, proficiency in Microsoft Office products, strong communication skills and detail oriented. - CU Fraud Detection Certification or equivalent Preferred Qualifications: - 3-5 years’ experience in administering a fraud prevention program. - Strong database and spreadsheet skills, perform complex analysis and draw logical conclusions for future modeling. - Strong database and spreadsheet skills, perform complex analysis and draw logical conclusions for future modeling. - CFE or CAMS certification - Bachelor’s degree in accounting, Finance or related business filed Education: - Associates Degree in Business Administration or Accounting or equivalent Website: nuvisionfederal.com/careers Pay scale by applicable geographic location: - Alaska: Min $33.22 - Mid - $41.52 - Max - $49.83 - Arizona: Min $29.28 - Mid - $36.61 - Max - $43.94 - Florida: Min $27.93 - Mid - $34.91 - Max - $41.90 - Nevada: Min $29.96 - Mid - $37.45 - Max - $44.95 - Texas: Min $28.20 - Mid - $35.25 - Max - $42.30 - Washington: Min $34.03 - Mid - $42.54 - Max - $51.05 - Wyoming: Min $28.88 - Mid - $36.10 - Max - $43.32 The final pay offered to a successful candidate will depend on several factors, including but not limited to the type and years of applicable experience within the job and industry, education, etc. Benefits: - Medical - Dental - Vision - Life Insurance - Flexible Spending Account - 401(k) Matching - Paid Time Off - Training Provided - Tuition Reimbursement Applicants must be legally authorized to work in the U.S. without the need for current or future sponsorship. Nuvision Credit Union is proud to be an Equal Opportunity Employer. At Nuvision Credit Union, we provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Nuvision Credit Union is committed to providing equal employment opportunities to all individuals, including those with disabilities. If you require a reasonable accommodation to complete the application or interview process, please contact our recruiting team at Recruiting@nuvisioncu.org. We will work with you to meet your needs in accordance with applicable laws.
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Credit Risk Modeling Senior Analyst
UnitedHealth GroupUnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Credit Risk Modeling Senior Analyst will play a key role in developing, enhancing, and maintaining quantitative credit risk models used for Current Expected Credit Losses (CECL), stress testing, and portfolio risk assessment. This role supports both commercial and retail lending portfolios and partners closely with Risk Management, Finance, and Data teams to ensure high quality, analytically sound estimates of expected and stressed credit losses. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. - Assist in the design, validation, and maintenance of models to support the Current Expected Credit Losses (CECL) framework, ensuring compliance with regulatory requirements - Assist in the design and execution of enterprise and regulatory stress testing methodologies (e.g., macroeconomic scenario expansion, loss forecasting, sensitivity analysis) - Support external and internal audit and model risk management inquiries for model related documentation - Conduct quantitative analysis as it applies to key business areas or specific types of models - Document models, assumptions, and methodologies in accordance with model governance and audit requirements - Effectively challenge the Bank’s models as requested, including conceptual soundness, assumptions, and appropriateness of model methodology - Collaborate with business groups to assist in developing effective modeling approaches to accurately represent the risks for practical business use - Identify and address potential process gaps or process improvements including data model requirement, structure and use, data governance, policy governance and other quantitative tools - Perform other assignments and special project analysis as requested by management Qualifications - Bachelor’s degree in Statistics, Applied Mathematics, Economics, Finance, Data Science, or a related quantitative discipline - 2+ years of hands-on experience developing, implementing, or validating credit risk models, including CECL, credit loss forecasting, regulatory stress testing, scorecard models, or early warning/behavioral risk models - 2+ years of programming experience using Python or SAS, with demonstrated ability to perform data manipulation, model development, model performance monitoring, and statistical analysis Requirements - Experience with CECL model development, implementation, or execution experience for Commercial Real Estate (CRE) and consumer lending portfolios - Proven solid knowledge of credit risk principles which inform credit loss forecasting - Ability to work in a fast-paced environment, manage competing priorities and to collaborate across the organization - Proven attention to detail and ensure data accuracy, reconciling and loading data - Ability to problem-solve effectively independently - Ability to communicate complex analytical issues in understandable terms appropriate for internal and external stakeholders Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements)

