Care Management Associate

Job not on LinkedIn

🔥 2 minutes 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

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

• Support comprehensive coordination of medical services • Perform Care Team intake, screening, and support implementation of care plans • Conduct initial review and triage of Care Team tasks • Identify admission reasons, facilities, and member products to apply intervention assessment tools • Screen patients using targeted intervention rules and processes • Identify needed medical services, make referrals, and coordinate services according to benefit plans • Monitor non-targeted cases for appropriate discharge dates and dispositions • Identify and refer outlier cases to clinical staff • Identify triggers for referral to Case Management, Mixed Services, and Specialty Programs • Use Med Compass and other Aetna systems to build, research, and enter member information • Coordinate and arrange healthcare service delivery under nurse or medical director direction • Identify opportunities to use participating providers and services at appropriate expense • Promote internal and external communication to enhance medical management services • Perform non-medical research for establishing, maintaining, and closing open cases • Provide support services to team members • Research information and assist in resolving problems • Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements • Protect confidentiality of member information • Assist with research and resolution of claims payment issues • Support hospital care, case management, and quality management processes in compliance with laws, regulations, URAQ, NCQA, and CMSA standards

🎯 Requirements

• 2-4 years of experience in a healthcare field, medical/health setting, medical billing, and coding • Experience in a call center or customer service environment • Ability to work independently and meet deliverables and deadlines • 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 • Commitment to high-quality service and supporting patient care outcomes • High School Diploma or G.E.D. • Ability to obtain a 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 workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to use multiple monitors and navigate multiple applications simultaneously • Experience with Microsoft Office 365 applications or similar tools such as Google Workspace • Ability to use secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues • Openness to learning new skills

🏖️ 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 (keyboard, monitor, computer, headset, etc.)

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