[Hiring] Case Manager Assistant @CVS Health

Role Description

The Case Manager Assistant is a work from home opportunity, supporting Case Managers with comprehensive coordination of services and follow up support to ALTCS (Arizona Long Term Care System) membership.

• Outreach to members and providers for care coordination.
• Make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
• Utilize Dynamo, QNXT, and other Aetna systems to build, research, and enter member information as needed.
• Coordinate and arrange for health care service delivery under the direction of the case manager.
• Promote communication, both internally and externally, to enhance effectiveness of service delivery.
• Perform non-medical research pertinent to the establishment, maintenance, and closure of open cases.
• Provide support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems.
• Adhere to compliance with AHCCCS (Arizona Health Care Cost Containment System) AM/PM (AHCCCS Medical Policy Manual) and Regulatory Standards.
• Maintain accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protect the confidentiality of member information and adhere to company policies regarding confidentiality.
• Support the case manager with post hospital follow-up and placement changes.
• Comfortable with long periods of sitting, as well as telephonic and computer work.
• Perform other duties as needed.

Qualifications

• 2+ years of experience in healthcare, as well as customer service, telemarketing, and/or sales.
• 1+ years of experience with computers, including knowledge of Microsoft Word, Outlook, Teams and Excel.
• Must reside in Arizona.
• Willingness to travel up to 10% of time within Maricopa, Pima, Pinal, and Gila Counties.

Requirements

• 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.
• Experience with data entry and documentation within member records.
• Proficiency in typing for keying in information and navigating in multiple systems.
• Ability to work independently with remote support.
• Excellent attendance record.
• Experience working with people who have been designated as having a serious mental illness (SMI) and working with people who are elderly or have a physical disability.
• Experience collaborating with medical professionals.
• Knowledge of ALTCS (Arizona Long Term Care System).
• Medical office experience and/or medical terminology knowledge.

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.

Company 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.