Care Management Associate

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona, California, +14 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🎰 Nevada – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ☕ Washington – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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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

• Coordinate medical services through intake and outgoing calls • 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 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 and take accurate messages • Support electronic transmission review and 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 with providers and health care team members • Obtain discharge dates and make referrals to the clinical team for follow-up • Work independently using judgment and critical thinking while 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 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 • Computer literacy, including Excel and Microsoft Word

🏖️ 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, based on eligibility