Care Management Specialist

Job not on LinkedIn

🔥 13 hours ago

🐊 Florida, Kentucky, +11 more states – Remote

🐊 Florida – Remote 🐎 Kentucky – Remote 🦞 Maine – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote

💵 $21 - $40 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 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

• Engage telephonically with members for 50–75% of the workday and coordinate their care • Conduct annual Health Risk Assessment Surveys • Address members’ social determinants of health needs • Close gaps in preventive and health maintenance care • Use available resources to engage hard-to-reach members • Develop individualized care plans with members, including goals and interventions • Document care management activities in members’ electronic health records • Collaborate with the Interdisciplinary Care Team to address barriers to care and maintain stable health conditions • Connect members with health plan benefits and community resources • Meet regulatory requirements within specified timelines • Consult with the Care Manager RN regarding clinical knowledge, medication regimens, and clinical decision-making • 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 effectively utilize Microsoft Office tools within the Care Manager Specialist role • Access to a private, dedicated workspace • Dependents must have separate care arrangements during work hours • Experience or willingness to learn care management within Medicare and Medicaid managed care • Familiarity with community resources and services • Ability to navigate and use healthcare technology tools • Effective verbal and written communication • Excellent customer service and engagement skills • Associate’s Degree with relevant experience in a health care-related field OR Practical Nurse Degree/Certificate with active licensure meeting state requirements (required) • Bilingual skills, especially English-Spanish, 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

🏖️ 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