[Hiring] Care Management Associate @CVS Health

Role Description

Support comprehensive coordination of medical services including:

• Care Team intake and outreach
• Screening and supporting the implementation of care plans to promote effective utilization of healthcare services
• Promoting/supporting quality effectiveness of benefits
• Responsible for initial review and outreach tasks
• Tracking Medicaid redetermination and researching eligibility issues
• Utilizing Dynamo, QNXT and other Aetna systems to build, research and enter member information, as needed
• Assisting Case Managers with coordination of benefits and services
• Promoting communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively)
• Providing support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems
• Adhering to Compliance with Policies and Regulatory Standards
• Maintaining accurate and complete documentation of required information that meets contract requirements
• Protecting the confidentiality of member information and adhering to company policies regarding confidentiality

Qualifications

• 2-4 years’ experience as a medical assistant or office assistant
• Strong customer service skills to coordinate service delivery
• Computer literacy to navigate through internal/external computer systems, including Excel and Microsoft Word
• Ability to effectively participate in a multi-disciplinary team including internal and external participants
• Effective communication, telephonic and organization skills

Requirements

• Familiarity with basic medical terminology and concepts used in care management (preferred)
• Medicaid/Medicare experience (preferred)
• Bachelor’s degree in health or human services field (preferred)

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families
• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources, based on eligibility