Case Management Specialist

Job not on LinkedIn

🔥 3 minutes ago

🐊 Florida, New Jersey, +3 more states – Remote

🐊 Florida – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌴 South Carolina – Remote

💵 $21 - $40 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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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 day and coordinate their care • Conduct member outreach using available resources to engage hard-to-reach members • Complete annual Health Risk Assessment Surveys • Address social determinants of health needs and close preventive and health maintenance care gaps • 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 and leverage the Care Manager RN’s clinical expertise for clinical knowledge, medication regimes, 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 • Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) • Ability to effectively utilize Microsoft Office tools within the Care Manager Specialist role • Access to a private, dedicated space to conduct work effectively • Dependents must have separate care arrangements during work hours • Associate’s Degree AND relevant experience in a health care-related field (REQUIRED) • Experience or willingness to thoroughly learn care management within Medicare and Medicaid managed care • Familiarity with community resources and services • Ability to navigate and utilize healthcare technology tools • Ability to meet performance and productivity metrics • Effective verbal and written communication • Excellent customer service and engagement skills • Preferred: 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 • Practical Nurse Degree/Certificate with active licensure meeting state requirements OR Bachelor’s Degree in health care or a related field (PREFERRED)

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to the base pay range • 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