Care Management Associate

CVS Health Corporation; Austin (TX); On-site; USD 25,000 - 48,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation, Austin, TX, is seeking a Care Management Associate to support coordination of medical services, including intake and outgoing calls. You will work with care management and utilization management teams to review eligibility and benefits and route cases for review as needed.

The role requires 2 years in medical/office settings and at least 6 months in a call center, with strong communication and organization skills.

Qualifications

• 2 years’ experience as a medical assistant, office assistant or related.
• Minimum of 6 months of call center experience required.
• Familiarity with basic medical terminology used in care management.
• Excellent communication and organizational skills.

Responsibilities

• Evaluates patients using targeted intervention rules and coordinates required services.
• Communicates health care service delivery based on nurse or medical director notes.
• Performs non-medical research for open cases and maintains documentation.
• Answers calls from providers and members, records messages, and supports referrals.
• Ensures documentation meets risk, regulatory and accreditation requirements.
• Maintains internal/external communication to enhance medical management services.
• Assists discharge dates and makes referrals to clinical teams for follow-up.
• Works independently when needed, following department guidelines and policies.
• Adapts with urgency and flexibility to meet changing environment and performance metrics.

Skills

Communication

Telephonic skills

Organizational skills

Customer service

Education

High School Diploma or GED

Tools

Excel

Microsoft Word

Job 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.

Schedule

• Schedule will be set; shifts will be based off a Central time schedule. The phone queue is open from 7am-6pm Central Time.
• Ideally, looking for someone to fill the 930am-6pm Central timeslot.

Position Summary

• The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services.
• We work closely with both case management and utilization management teams.
• The Care Management Associate will review eligibility and benefits, open pre-certification cases, and either approve or send to nursing staff for review.

Additional Responsibilities Include But Not Limited To The Following

• Evaluates 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 by the benefit plan.
• Communicates health care service delivery as required based on outcomes/reviews noted by the nurse or medical director
• Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases.
• Provides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropriate, utilizes internal tools to determine required steps to ensure proper review based on clinical requirements as well as established plan guidelines.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Ensures communication, both internally and externally, to enhance the effectiveness of medical management services (e.g., health care providers, and health care team members respectively).
• Assist in obtaining discharge dates and making appropriate referrals to clinical team for their engagement in additional follow up as needed.
• Completes work independently on occasion while executing good judgment and critical thinking skills while adhering to Department guidelines, policies, and procedures.
• Operates with a sense of urgency and flexibility to meet the needs of a rapidly changing environment, while meeting performance standards set for quality and quantity of work.

Required Qualifications

• 2 years’ experience as a medical assistant, office assistant or related experience.
• Minimum of 6 months of call center experience required.

Preferred Qualifications

• Effective communication, telephonic and organization skills.
• Familiarity with basic medical terminology and concepts used in care management.
• 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.
• Computer literacy to navigate through Internal/external computer systems, including Excel and Microsoft Word.

Education

• High School Diploma or equivalent GED

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$18.50 - $35.29

This 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 People

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/15/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.