Care Management Associate

CVS Health; New Jersey; Remote; USD 80,000 - 100,000; Full time

Job summary

Join a forward-thinking organization dedicated to transforming health care! As a Care Management Associate, you'll play a pivotal role in enhancing patient care for dual eligible populations. This position offers a unique opportunity to make a life-changing impact on members enrolled in Medicare and Medicaid. Collaborating with members, providers, and community organizations, you'll address diverse health and social challenges while ensuring effective communication and support. With a commitment to innovation and compassionate care, this role is perfect for those looking to contribute to meaningful change in health care delivery. Don't miss out on this chance to be part of a team that truly cares!

Benefits

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Employee Stock Purchase Plan

Fully-paid term life insurance

Short-term and long-term disability benefits

Paid Time Off (PTO)

Paid holidays

CVS store discount

Qualifications

• 2 years of experience in customer service, telemarketing, or sales.
• High School diploma or equivalent experience required.

Responsibilities

• Schedule assessments and coordinate health care service delivery.
• Maintain accurate documentation and adhere to compliance standards.

Skills

Customer Service

Communication Skills

Telemarketing

Sales

Education

High School diploma or equivalent

Tools

Dynamo

QNXT

Job description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Framework: 106

JVS Code: 440404 Care Management Associate

Position Summary:

Help us elevate our patient care to a whole new level! Join our Aetna FIDE team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in markets across the country.

Responsibilities:

• Initial outreach and scheduling of assessments
• Utilizes Dynamo, QNXT, state agency systems and other Aetna systems to build, research, and enter member information as needed.
• Support the development and implementation of care plans.
• Coordinates and arranges for health care service delivery under the direction of the nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the member to utilize participating providers and services.
• Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g. health care providers and health care team members.)
• Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases.
• 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 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.
• May assist in the research and resolution of claims payment issues.

Required Qualifications: 2 years of experience preferably in customer service, telemarketing and/or sales.

Preferred Qualifications: MCO experience

Work Schedule: Monday through Friday 8am-5pm (Must work the Eastern Time Zone hours, but can sit anywhere in the US)

Education: High School diploma, G.E.D or equivalent experience.

Pay Range:

The typical pay range for this role is: $18.50 - $37.02. 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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits.

We anticipate the application window for this opening will close on: 03/26/2024.

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [e-mail]. If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.