Care Management Associate

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Evaluate patients using targeted intervention business rules and processes • Identify needed medical services and make appropriate referrals • Coordinate required services according to the benefit plan • Communicate health care service delivery based on nurse or medical director reviews • Perform non-medical research for establishing, maintaining, and closing open cases • Answer provider and member telephone calls and take accurate messages • Support electronic transmission review and referrals • Use internal tools to determine required review steps based on clinical requirements and plan guidelines • Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements • Promote internal and external communication to improve medical management services • Obtain discharge dates and make referrals to the clinical team for follow-up • Perform initial review and triage of Care Team tasks • Identify admission reason, facility, and member product to apply intervention assessment tools • Use Aetna systems to build, research, and enter member information • Support development and implementation of care plans • Coordinate health care delivery under nurse or medical director direction in appropriate settings and at appropriate expense • Assist with research and resolution of claims payment issues • Support hospital care, case management, and quality management processes in compliance with applicable standards, laws, regulations, and company procedures • Protect member confidentiality • Complete work independently using judgment and critical thinking while meeting quality and productivity standards

🎯 Requirements

• 2 years of experience in customer service, telemarketing and/or sales • Proficiency in typing and navigating multiple systems • Computer experience, including Microsoft Word, Outlook, and Excel • High School diploma or equivalent GED • Must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private, designated home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to use multiple monitors and navigate multiple applications simultaneously • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer and information-security practices • Ability to troubleshoot common technical issues independently • Requires long periods of sitting and telephone and computer work • Preferred: data entry and documentation within member records • Preferred: medical office experience • Preferred: call center experience • Preferred: medical terminology knowledge • Preferred: strong telephonic communication skills • Preferred: strong organizational skills and ability to prioritize time-sensitive tasks • Preferred: effective verbal and written communication skills • In the requisition details: high school diploma or 5+ years equivalent experience; 5+ years prior relevant work experience; adept problem-solving and decision-making skills

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.)

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