Care Mgt Associate

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

Training is 4 weeks, then 8 weeks with a preceptor.

8 hour shifts

Start Times Available:

• 9:00am EST – 11am EST

The Care Management Associate supports comprehensive coordination of medical services including Care team intake, screening, and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. 

The Care Management Associate position duties include (not all encompassing):

-Responsible for initial review and triage of Care Team tasks.

-Identifies principal reason for admission, facility, and member product to correctly apply intervention assessment tools.

-Utilizes Aetna systems to build, research and enter member information, as needed.

-Supports the development and implementation of Care Plans.

-Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services

-Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively)

-Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases

-Provides support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems.

-Adheres to compliance with policies and regulatory standards.

-Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.

-Protects the confidentiality of member information and adheres to company policies regarding confidentiality.

-May assist in the research and resolution of claims payment issues.

-Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures.

Required Qualifications

• 2 years of experience in either customer service, telemarketing and/or sales
• Proficiency in typing for keying in information and navigating in multiple systems
• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel
• Requires long periods of sitting and telephone and computer work.

Preferred Qualifications

• Data entry and documentation within member records
• Medical office experience
• Call center experience
• Medical terminology knowledge
• Strong telephonic communication skills
• Strong organizational skills with an ability to prioritize tasks to meet time-sensitive deadlines
• Effective verbal and written communications skills with both customers and teammates

Education

High School diploma, or equivalent GED

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<