Care Management Associate Member Connection

CVS Health Corporation; South Dakota; Hybrid; USD 53,010,000 - 121,350,000; Full time

Benefits offered by this job

Medical Insurance

Dental Coverage

Vision Coverage

Retirement Savings Options

Paid Time Off

Job summary

CVS Health is hiring for a Care Management Associate on the Aetna Medicaid Member Connections team. This role focuses on telephonic outreach, enrollment, and care plan facilitation to promote effective healthcare utilization and outcomes.

The Associate must coordinate with care managers, document interactions in member records, and support compliance with privacy and regulatory standards while delivering empathetic service.

Qualifications

• 1-2+ years strong customer service skills coordinating service delivery.
• Completes documentation of each member call in the electronic record with detail.
• Works independently meeting deliverables with a caring telephonic presence.
• Ability to participate in a multi-disciplinary team.
• Effective communication, organization and adaptability to changing priorities.
• Demonstrates ability to meet daily metrics with speed and accuracy.
• 2-4 years’ experience in call center healthcare preferred.
• Familiarity with Word, Outlook, and Excel for data entry and documentation.
• Familiarity with basic medical terminology used in care management.
• Flexibility to work nights and weekends; bilingual Spanish preferred.

Responsibilities

• Direct member outreach and engagement, facilitating case assignment.
• Connect identified members to care managers immediately through a warm transfer.
• Provide support by answering calls, taking messages, and researching information.
• Maintain documentation meeting risk management, regulatory and accreditation requirements.
• Protect confidentiality of member information and adhere to policies.

Skills

Customer service

Communication

Documentation

Team participation

Multitasking

Organizational skills

Education

HS Diploma

Tools

Microsoft Word

Outlook

Excel

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.

Aetna’s Medicaid Care Management Member Connections Team is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members’ needs and create behavioral change. How we do this is through a dedicated and caring team of health care professionals who connect with passion, caring and behavioral interviewing techniques. This team has a drive to exceed the delivery of Medicaid Health care services. Focus is on the Member Connection Team efficiency and productivity efforts whereby the Care Management Associates interact and engage telephonically with members. Through the successful supports orchestrated by the Member Connections team, this comprehensive care coordination is a collaborative demonstration of innovative healthcare navigation and motivational health plan customer support representation. This is an exciting time to join Aetna, a CVS Health Company, in our journey to change the way healthcare is delivered today. We are health care innovators.

The Member Connections Care Management Associate supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of our eligible members. Our Engagement Care Management Associates demonstrate a highly energetic blend of salesperson, healthcare navigator and health plan customer support representative. The Associate is responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through a warm transfer. By successfully enrolling members into care management, further supports the implementation of care plans to promote effective utilization of healthcare services, promoting and supporting quality effectiveness.

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 procedure/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.

REQUIRED QUALIFICATIONS:

• 1-2+ years 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, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures).

• Completes documentation of each member call in the electronic record, thoroughly completing required actions with a high level of detail to ensure compliance requirements are met with efficiency.

• Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring presence telephonically.

• Ability to effectively participate in a multi-disciplinary team including internal and external participants.

• Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.

• Demonstrates ability to meet daily metrics with speed, accuracy and a positive attitude.

PREFERRED QUALIFICATIONS :

• 2 - 4 years’ experience in call center healthcare field (i.e. experienced in medical office, hospital setting, medical billing/coding) preferred.

• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records preferred.

• Familiarity with basic medical terminology and concepts used in care management preferred.

• Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am to 8:00 pm.

• Strong organizational skills, including effective verbal and written communication skills.

• Bilingual (Spanish) preferred.

• LA Medicaid experience

EDUCATION:

HS Diploma required

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

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 (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 10/16/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.