Care Management Associate

Job not on LinkedIn

🔥 1 hour 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, including Care Team intake, screening, and care plan implementation • Perform initial review and triage of Care Team tasks • Identify the principal reason for admission, facility, and member product to apply intervention assessment tools correctly • Screen patients using targeted intervention business rules and processes to identify needed medical services • Refer patients to medical services staff and coordinate services according to the benefit plan • Monitor non-targeted cases for appropriate discharge date and disposition entry • Identify outlier cases and refer them to clinical staff • Identify triggers for referral into Aetna Case Management, Mixed Services, and other Specialty Programs • Use Med Compass and Aetna systems to build, research, and enter member information • Support development and implementation of care plans • Coordinate and arrange healthcare service delivery under nurse or medical direction in the appropriate setting and at the most appropriate expense • Identify opportunities for patients to use participating providers and services • Promote internal and external communication with healthcare providers and healthcare team members • Perform non-medical research for establishing, maintaining, and closing open cases • Provide support services to team members • Assist with researching and resolving claims payment issues • Support hospital care, case management, and quality management processes in compliance with laws, regulations, URAQ, NCQA, and CMSA standards and company policies • Complete 4-8 weeks of weekday training before transition to the weekend schedule • Work Saturday through Tuesday, 7:00 AM to 5:30 PM, 10-hour shifts

🎯 Requirements

• 2-4 years of experience within the healthcare field, medical/health setting, medical billing, and coding • Experience in a call center or customer service environment • Ability to work independently, meet deliverables and deadlines, and demonstrate an outgoing, enthusiastic, and caring presence telephonically • 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 and ability to navigate computer systems and digital tools efficiently • Ability to collaborate effectively with clinical teams • Excellent communication skills for interacting with providers and internal stakeholders • Ability to research information and assist in solving problems • Compliance with PM policies and regulatory standards • Ability to maintain accurate and complete documentation meeting risk management, regulatory, and accreditation requirements • Ability to protect the confidentiality of member information and follow company confidentiality policies • Demonstrated ability to handle multiple assignments accurately and efficiently • Knowledge of medical terminology • High School Diploma or G.E.D. • 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 • Quiet, secure, private, designated home work location compliant with CVS Health and HIPAA guidelines • Ability to work within the state and city where currently living • Ability to provide workspace furniture for extended desk work • Comfort setting up and using multiple monitors and navigating multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to log in to secure systems such as VPN and EHR portals, secure devices, manage strong passwords, and recognize suspicious emails or links • Ability to resolve common technical issues independently and contact IT when necessary • Openness to learning new skills as the workplace evolves • Weekend and holiday availability required

🏖️ 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 including keyboard, monitor, computer, and headset

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