Bilingual Case Management Analyst

CVS Health is seeking a Bilingual Case Management Analyst to support members on their path to better health. In this role, you will conduct bilingual outreach, assess clinical and social needs, and analyze benefits and claims data to identify gaps in care. You will develop person-centered case management plans, coordinate services and community resources, and educate members on their coverage and care options. Working within a collaborative, purpose-driven team, you will document all activities in case management systems while upholding HIPAA and regulatory standards, helping improve outcomes and access for diverse populations.

Responsibilities

• Conduct bilingual outreach to members to assess health, social, and benefit needs
• Analyze clinical, claims, and benefits data to identify gaps in care and service needs
• Develop and maintain person-centered case management plans
• Coordinate appointments, referrals, and community resources for members
• Educate members on benefits, care options, and care navigation in their preferred language
• Document assessments, care plans, and interventions in case management systems
• Collaborate with nurses, social workers, providers, and internal teams to optimize care
• Monitor member progress and adjust care plans to support better outcomes
• Ensure compliance with HIPAA, regulatory, and CVS Health policies
• Report trends, barriers, and opportunities to improve programs and member experience

Required Skills

• Bilingual communication (e.g., English/Spanish)
• Case management and care coordination
• Healthcare benefits and claims analysis
• Knowledge of Medicaid/Medicare or commercial health plans
• Electronic case management/CRM systems
• Data interpretation and reporting
• Understanding of HIPAA and healthcare compliance
• Member assessment and care planning
• Healthcare documentation and record-keeping
• Customer service and de-escalation skills