Care Management Associate

Job not on LinkedIn

🔥 15 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $18 - $35 / 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 through intake and outgoing calls • Work closely with case management and utilization management teams • Review eligibility and benefits • Open pre-certification cases and approve them or send them to nursing staff for review • Evaluate patients using targeted intervention business rules and processes • Identify needed medical services, make appropriate 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 and take accurate messages • Support electronic transmission review and referrals as appropriate • Use internal tools to determine required steps for review based on clinical requirements and plan guidelines • Maintain accurate and complete documentation meeting risk management, regulatory and accreditation requirements • Communicate internally and externally with health care providers and health care team members • Obtain discharge dates and make appropriate referrals to the clinical team for follow-up • Work independently using judgment and critical thinking while following department guidelines, policies and procedures • Meet quality and quantity performance standards in a rapidly changing environment

🎯 Requirements

• 2 years’ experience as a medical assistant, office assistant or related experience • Minimum of 6 months of call center experience required • High School Diploma or equivalent GED • Effective communication, telephonic and organization skills • Familiarity with basic medical terminology and concepts used in care management • Strong customer service skills, including attention to customers, sensitivity to issues, proactive identification and resolution of issues • Computer literacy to navigate internal and external computer systems, including Excel and Microsoft Word

🏖️ 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 in addition to base pay

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