[Hiring] Care Management Associate - Engagement Hub @CVS Health

Role Description

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.

This position is remote and the working hours are 8am-5pm EST.

Aetna’s Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members’ needs and create behavioral change. This team has a drive to exceed the delivery of Medicaid Health care services. Focus is on the Hub’s efficiency and productivity efforts whereby the Care Management Associates interact and engage telephonically with members.

The Engagement Outreach Hub Care Management Associate supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of our eligible members. Our Engagement Care Management Associates demonstrate a highly energetic blend of salesperson, healthcare navigator and health plan customer support representative.

• Responsible for direct member outreach and engagement.
• Facilitates case assignment and connects identified members to care managers immediately through a warm transfer.
• Successfully enrolls members into care management to support the implementation of care plans.
• 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 procedure/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.

Qualifications

• 2 years’ experience in healthcare field (i.e. experienced in medical office, hospital setting, medical billing/coding) preferred.
• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records preferred.
• Familiarity with basic medical terminology and concepts used in care management preferred.
• Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am to 8:00 pm.
• Strong organizational skills, including effective verbal and written communication skills.
• Bilingual (Spanish) preferred.

Requirements

• Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.
• Demonstrates ability to meet daily metrics with speed, accuracy and a positive attitude.
• Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
• Completes documentation of each member call in the electronic record, thoroughly completing required actions with a high level of detail to ensure compliance requirements are met with efficiency.
• Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring presence telephonically.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants.
• Bilingual (Spanish) preferred.

Education

• High School diploma or equivalent GED.
• The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent.

Benefits

• Comprehensive and competitive mix of pay and benefits.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.