Care Management Associate

Job not on LinkedIn

🔥 16 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $18 - $42 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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• Open for 1 day.
• Jobs at this company usually fill in 21 days.

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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 the coordination of healthcare services through intake, screening, referral management, and care plan implementation. • Conduct initial review and triage of Care Team tasks and member cases. • Identify the principal reason for admission, facility type, and member product to accurately apply assessment and intervention tools. • Screen members using established clinical and business rules to identify appropriate healthcare services and referrals. • Coordinate services in accordance with benefit plans and organizational guidelines. • Monitor cases to ensure accurate discharge dates and dispositions are documented. • Identify and escalate complex or outlier cases, including extended length-of-stay situations, to clinical staff. • Recognize opportunities for referral to Case Management, Disease Management, Specialty Programs, and other care management services. • Assist with the development, implementation, and coordination of care plans under the direction of nurses and medical directors. • Help members access appropriate providers and services while supporting cost-effective care delivery. • Promote member engagement and continuity of care. • Serve as a primary point of contact for members, providers, and internal stakeholders. • Facilitate communication between healthcare providers, care teams, and business partners. • Provide administrative and operational support, respond to inquiries, research information, and resolve routine issues. • Maintain timely, accurate, and complete case documentation in accordance with policies, regulations, accreditation standards, and risk management guidelines. • Protect member confidentiality and ensure HIPAA and privacy compliance. • Support hospital care management, utilization management, quality management, and case management processes. • Assist with research and resolution of claims payment inquiries. • Utilize internal healthcare management systems to research, update, and maintain member information. • Perform non-clinical research and maintain accurate records across multiple systems and platforms.

🎯 Requirements

• High School Diploma or GED required. • 1+ year of experience in healthcare, call center, customer service, care coordination, case management support, utilization management, health insurance, hospital operations, or a related field. • Strong verbal and written communication skills. • Excellent organizational skills with the ability to manage multiple priorities in a fast-paced environment. • Proficiency with Microsoft Office Suite, including Outlook, Teams, Word, and Excel. • Ability to handle confidential and sensitive information professionally. • Strong problem-solving and customer service skills. • Associate’s or Bachelor's degree in Healthcare Administration, Public Health, Nursing, Social Services, or a related field preferred. • Experience in managed care, healthcare operations, utilization management, case management, or health insurance preferred. • Knowledge of medical terminology, healthcare delivery systems, and insurance benefits preferred. • Experience working with electronic medical records (EMRs), healthcare databases, or care management platforms preferred. • Familiarity with NCQA, URAC, CMSA, HIPAA, and regulatory healthcare standards preferred. • Experience supporting members, providers, or clinical teams in a healthcare environment preferred.

🏖️ 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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