Care Management Associate Must reside in Eastern Standard Time
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At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
This Care Management Associate position is 100% remote and work from home. Employee must reside in Eastern Standard Time zoneNormal working hours are Monday through Friday 9:30am-6:00pm EST with occasional rotating Saturday and holiday shifts on rotation per the needs of the team.T here is no travel required with this position.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.
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-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
-Must reside in Eastern Standard Time
-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 teammatesEducation
High School diploma, GED, and/or equivalent years of experience Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$18.50 - $35.29This 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 peopleWe 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:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
Perks and Benefits
Health and Wellness
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- HSA
- HSA With Employer Contribution
- Pet Insurance
- Mental Health Benefits
Parental Benefits
- Fertility Benefits
- Adoption Assistance Program
- Family Support Resources
Work Flexibility
- Flexible Work Hours
- Remote Work Opportunities
- Hybrid Work Opportunities
Office Life and Perks
Vacation and Time Off
- Paid Vacation
- Paid Holidays
- Personal/Sick Days
Financial and Retirement
- 401(K) With Company Matching
Professional Development
- Tuition Reimbursement
Diversity and Inclusion
- Employee Resource Groups (ERG)
- Diversity, Equity, and Inclusion Program