Care Management Associate — Health Plan & Transplant Coordination

CVS Health; Florida; Remote; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in the United States is seeking a medical assistant for the National Medical Excellence Program to coordinate inbound calls from the phone queue. You will use Aetna systems to build, research and enter member information, supporting eligibility and benefits verification.

The role emphasizes documentation, risk management and compliance, teamwork with clinical staff, and obtaining authorizations for transplant services where required, while protecting privacy and adhering to policies

Qualifications

• 2+ years’ experience in medical/clinical support roles.
• Strong computer skills including Excel and MS Office.
• Ability to communicate with diverse populations.
• Ability to collaborate in a team environment.

Responsibilities

• Assist with intake of calls from providers or members.
• Use Aetna systems to build, research and enter member information.
• Perform non-medical research including eligibility and benefits verification.
• Maintain accurate documentation and comply with risk, regulatory and accreditation requirements.
• Process referrals, outreach calls, and data entry as needed.
• Collaborate with clinical team, medical directors, claims and staff.

Skills

Communication

Teamwork

Independent work

Diversity communication

Education

High School Diploma or GED

Associate Degree preferred

Tools

Microsoft Excel

Microsoft Office Suite

Job description

CVS Health in the United States is seeking a medical assistant for the National Medical Excellence Program to coordinate inbound calls from the phone queue. You will use Aetna systems to build, research and enter member information, supporting eligibility and benefits verification.

The role emphasizes documentation, risk management and compliance, teamwork with clinical staff, and obtaining authorizations for transplant services where required, while protecting privacy and adhering to policies