Care Management Associate

Job not on LinkedIn

🕒 August 10

🌵 Arizona – Remote

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💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 23%

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 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 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 benefit plans • Communicate health care service delivery based on nurse or medical director reviews • Perform non-medical research for establishing, maintaining, and closing cases • Answer provider and member telephone calls, take accurate messages, review electronic transmissions, and make referrals • Use internal tools to determine required steps based on clinical requirements and plan guidelines • Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements • Coordinate internal and external communication to support medical management services • Obtain discharge dates and refer cases to the clinical team for follow-up • Work independently while applying judgment and critical thinking and following department guidelines • 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 • 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 • Computer literacy, including Excel and Microsoft Word • Ability to work Monday through Friday, 8:30 AM to 5:00 PM Arizona time • Ability to work 40 hours per week

🏖️ Benefits

• Comprehensive 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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