Care Manager Associate
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Remote • Louisiana, Mississippi, Montana, North Carolina, Virginia • 🇺🇸 United States
Visit company websiteSalary
💰 $19 - $35 per hour
Job Level
JuniorMid-Level
About the role
- 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.
- Responsible for initial review and triage of Care Team tasks.
- Identifies principle reason for admission, facility, and member product to correctly apply intervention assessment tools.
- Screens patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
- Monitors non-targeted cases for entry of appropriate discharge date and disposition.
- Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs.
- Utilizes eTUMS and other 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.
Requirements
- 1-3 years of experience in General Business or Maximizing Work Practices experience
- Basic knowledge of Benefits Management
- Basic knowledge of Interacting with Medical Professionals
- Basic knowledge of Service/Handling Service Challenges
- Minimum of 1-3+ years experience as a medical assistant, office assistant, or related healthcare/medical role required.
- Strong customer service skills to coordinate service delivery including attention to members and providers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
- High School diploma, G.E.D. or equivalent experience.
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care plan implementationintervention assessment toolspatient screeningreferral coordinationdischarge monitoringcase managementdisease managementhealthcare service deliverybenefits managementmedical assistance
Soft skills
customer servicecoordinationattention to detailsensitivityproactive problem solvingcommunicationinterpersonal skillsorganizational skillsteam collaborationissue resolution
Certifications
High School diplomaG.E.D.