Care Management Specialist

Job not on LinkedIn

🔥 13 hours ago

🐊 Florida – Remote

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💵 $21 - $40 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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Logo of CVS Health

CVS Health

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

• Engage telephonically with members for 50–75% of the workday • Coordinate care for Special Needs Plan members, particularly those with social determinants of health needs and stable health conditions • Complete annual Health Risk Assessment Surveys • Identify and address social determinants of health needs • Close gaps in preventive and health maintenance care • Use available resources to reach and engage hard-to-reach members • Develop individualized care plans with members • Document care management activities in members’ electronic health records • Collaborate with the Interdisciplinary Care Team to address barriers to care • Connect members with health plan benefits and community resources • Meet regulatory requirements within specified timelines • Consult with and leverage the Care Manager RN’s clinical expertise • Support team objectives and operational efficiency • Participate in special projects and process improvement initiatives • Assist with mentoring new team members

🎯 Requirements

• 2+ years of experience in a health-related field • 2+ years of customer service experience • Proficiency in Microsoft Office Suite: Word, Excel, Outlook, OneNote, and Teams • Ability to utilize healthcare technology tools • Access to a private, dedicated workspace • Dependents must have separate care arrangements during work hours • Associate’s Degree with relevant experience in a health care-related field OR Practical Nurse Degree/Certificate with active licensure that meets state requirements (REQUIRED) • Experience or willingness to learn care management within Medicare and Medicaid managed care • Familiarity with community resources and services • Effective verbal and written communication • Excellent customer service and engagement skills • Ability to meet performance, productivity, call volume, member engagement, and regulatory metrics • Bachelor’s Degree in health care or a related field (PREFERRED) • Experience providing care management for Medicare and/or Medicaid members (PREFERRED) • Experience with SDoH needs, chronic medical conditions, and/or behavioral health (PREFERRED) • Experience conducting health-related assessments and facilitating care planning (PREFERRED) • Bilingual skills, especially English-Spanish (PREFERRED)

🏖️ 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

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