Care Management Associate

Job not on LinkedIn

🔥 1 hour ago

🌵 Arizona – Remote

infoinfo

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

Where this job comes from

Posted on CVS Health Careers's careers page, not through a job board

First seen by Remote Rocketship 1 hour ago

Logo of CVS Health Careers

CVS Health Careers

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

• Support comprehensive coordination of medical services, including intake and outgoing calls • Work closely with case management and utilization management teams • Review eligibility and benefits and open pre-certification cases • Approve cases or send them to nursing staff for review • Evaluate patients using targeted intervention business rules and processes • Identify needed medical services, make referrals, and coordinate services according to the benefit plan • Communicate health care service delivery based on nurse or medical director outcomes and reviews • Perform non-medical research for establishing, maintaining, and closing open cases • Answer provider and member telephone calls, take accurate messages, review electronic transmissions, and make 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 • Communicate internally and externally to enhance medical management services • Obtain discharge dates and make referrals to the clinical team for follow-up • Work independently when needed using judgment and critical thinking while following department guidelines • Meet quality and quantity performance standards in a rapidly changing environment

🎯 Requirements

• Candidates must be located in Arizona • 2 years’ experience as a medical assistant, office assistant or related experience • Minimum of 6 months of call center experience required • Effective communication, telephonic and organization skills • Familiarity with basic medical terminology and concepts used in care management • Strong customer service skills • Computer literacy, including Excel and Microsoft Word • High School Diploma or equivalent GED • Ability to work Monday through Friday, 8:30 AM to 5:00 PM Arizona time

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility

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