Care Management Associate

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CVS Health

WebsiteLinkedInAll Job Openings

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

• Coordinate medical services, including intake and outgoing calls • 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 outcomes and reviews • Perform non-medical research for establishing, maintaining, and closing open cases • Answer provider and member calls, take accurate messages, review electronic transmissions, and make referrals • Use internal tools to determine required review steps based on clinical requirements and plan guidelines • Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements • Communicate internally and externally to improve medical management services • Obtain discharge dates and make appropriate referrals for additional clinical follow-up • Work independently when needed while following department guidelines, policies, and procedures • Meet quality and quantity performance standards in a rapidly changing environment

🎯 Requirements

• Candidates must be located in Arizona • 2 years’ experience as a medical assistant, office assistant, or related role • 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 care management concepts • Strong customer service skills • Computer literacy with internal and external computer systems • Proficiency with Excel and Microsoft Word • Ability to work Monday through Friday, 8:30 AM to 5:00 PM Arizona time

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility