Case Management Specialist

Job not on LinkedIn

🔥 18 hours ago

🦌 Connecticut, Florida, +7 more states – Remote

🦌 Connecticut – Remote 🐊 Florida – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🚗 Michigan – Remote 🎸 Mississippi – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🤠 Texas – 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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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 • 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 • Address social determinants of health needs and close preventive and health maintenance care gaps • Conduct outreach to hard-to-reach members using available resources • 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 members’ stable health • 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 for clinical knowledge, medication regimens, and supportive 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, including Word, Excel, Outlook, OneNote, and Teams • Ability to effectively use Microsoft Office tools within the Case Management Specialist role • Associate’s degree and relevant experience in a health care-related field (required) • Access to a private, dedicated workspace • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Practical Nurse Degree/Certificate with active licensure meeting state requirements or bachelor’s degree in health care or related field (preferred) • Experience or willingness to learn care management within Medicare and Medicaid managed care • Familiarity with community resources and services • Ability to navigate healthcare technology tools • Ability to meet performance, productivity, call volume, member engagement, and regulatory metrics • Effective verbal and written communication skills • Excellent customer service and engagement skills • Experience providing care management for Medicare and/or Medicaid members (preferred) • Experience with individuals 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) • Ability to use multiple monitors and applications simultaneously • Experience with Microsoft Office 365 applications or similar tools such as Google Workspace • Ability to use secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Openness to learning new skills as the workplace evolves

🏖️ 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 • Company-provided equipment, including keyboard, monitor, computer, and headset • Remote work from a designated home workspace