Care Management Associate

Job not on LinkedIn

🔥 1 minute ago

🐊 Florida, North Carolina, +6 more states – Remote

🐊 Florida – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.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 the National Medical Excellence Program by handling inbound calls from the phone queue • Perform call intake from providers and members • Use Aetna systems including MedCompass, HRP, ASD, CEC, and ATV to build, research, and enter member information • Conduct non-medical research, including eligibility, coordination of benefits, and benefits verification • Maintain accurate documentation and meet risk management, regulatory, and accreditation requirements • Process referrals, make outreach calls, and enter data via telephone, fax, and EDI • Collaborate with clinical teams, medical directors, claims, and contacting staff • Communicate with transplant financial coordinators, members, providers, Aetna nurses, and medical directors • Initiate kidney transplant authorizations according to unit processes • Build shell cases for transplant, cellular therapy, and gene therapy requests and task them for nurse review • Promote internal and external communication to enhance medical management services • Protect member confidentiality and follow company confidentiality policies • Support precertification administration in compliance with applicable laws, regulations, NCQA standards, and company procedures • Perform sedentary work involving sitting, talking, hearing, and keying • Perform close inspection of written and computer-generated documents • Perform other duties as assigned

🎯 Requirements

• 2+ years’ experience working as a medical assistant, office assistant or other clinical/equivalent experience • Computer skills, including Microsoft Office Suite, specifically Excel • Ability to communicate with diverse populations • Ability to collaborate with and work in a team environment • Flexibility and ability to work independently • High School Diploma or equivalent GED required • 40 hours per week • Preferred: 1+ years prior insurance experience, preferably in a call center • Preferred: Telephonic customer service experience • Preferred: 1+ years of prior authorization experience • Associate Degree 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 in addition to base pay