Care Management Associate

Job not on LinkedIn

🔥 18 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $18 - $38 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Support comprehensive coordination of medical services • Perform Care Team intake and screening • Support implementation of care plans • Conduct initial review and triage of Care Team tasks • Identify admission reasons, facilities, and member products to apply intervention assessment tools • Screen patients using targeted intervention business rules and processes • Identify needed medical services and make appropriate referrals • Coordinate required services according to the benefit plan • Monitor non-targeted cases for appropriate discharge dates and dispositions • Identify and refer outlier cases to clinical staff • Identify triggers for referral to Aetna Case Management, Mixed Services, and Specialty Programs • Use Med Compass and other Aetna systems to build, research, and enter member information • Coordinate and arrange healthcare service delivery under nurse or medical director direction • Identify opportunities to use participating providers and services • Promote internal and external communication to improve medical management effectiveness • Conduct non-medical research for establishing, maintaining, and closing open cases • Provide support services to team members • Research and assist with resolving claims payment issues • Support hospital care, case management, and quality management processes in compliance with laws, regulations, URAQ, NCQA, and CMSA standards • Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements • Protect member confidentiality and follow company policies

🎯 Requirements

• 2-4 years of experience in the healthcare field, medical/health setting, medical billing, and coding • Experience in a call center or customer service environment • Ability to work independently and meet deliverables and deadlines • Ability to meet daily metrics with speed and accuracy • Strong written and oral communication skills • Ability to work efficiently across multiple systems simultaneously, including Microsoft Office 365 applications, clinical platforms, and health plan systems • Technical proficiency navigating computer systems and digital tools • Ability to collaborate effectively with clinical teams • Excellent communication skills for interacting with providers and internal stakeholders • Commitment to high-quality service and patient care outcomes • High School Diploma or G.E.D. • Knowledge of medical terminology • Ability to obtain a direct/hardwired internet connection with minimum 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to use multiple monitors and applications simultaneously • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to use secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues

🏖️ Benefits

• 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.) • CVS Health bonus, commission or short-term incentive program eligibility

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