Care Management Associate

Job not on LinkedIn

🔥 32 minutes ago

🏈 Alabama, Arizona, +43 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote 🍑 Georgia – Remote

💵 $18 - $38 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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• Just posted.
• Jobs at this company usually fill in 21 days.

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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

• Review, intake, screen, and triage Utilization Management and Care Management work • Gather, research, and validate member, provider, facility, admission, authorization, and other case information • Prepare cases and route work to nurses, medical directors, and other clinical partners • Conduct outbound outreach to providers and facilities • Monitor work for missing information, discharge information, documentation needs, or follow-up conditions • Identify triggers for referrals or handoffs to Care Management, Disease Management, Transition of Care, and other clinical programs • Document calls, actions, research, outcomes, and follow-up activities in designated systems • Navigate multiple systems, work queues, provider portals, and technology tools while maintaining data accuracy • Perform non-clinical research to establish, maintain, process, and close cases • Manage assigned work within turnaround times and escalate barriers or aging work • Meet productivity and quality expectations while supporting positive experiences for members, providers, and internal partners • Protect PHI/PII and comply with applicable requirements

🎯 Requirements

• 2+ years of experience in health insurance, healthcare operations, provider services, medical office operations, Utilization Management/Care Management support, prior authorization, or a comparable healthcare environment • High school diploma or GED • Strong attention to detail • Effective time management • Ability to work across multiple systems, applications, and work queues • Ability to follow established workflows and business rules • Ability to adapt to changing processes and technology • Ability to meet turnaround time, productivity, quality, and documentation expectations • Ability to protect PHI/PII and comply with HIPAA, privacy, security, regulatory, accreditation, and company requirements • Associate degree or higher in healthcare, business, or a related field (preferred)

🏖️ Benefits

• Comprehensive medical, dental, and 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 eligibility

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