Remote Care Management Associate

CVS Health Corporation

Northern (KY)

Hybrid

USD 25,000 - 54,000

Full time

8 days ago

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Benefits offered by this job

Remote work

Job summary

CVS Health Corporation is hiring for a full-time Care Management Associate (CMA) to support coordination of medical and social services for members. You will assist with care team intake, task triage, outreach, and care plan implementation, promoting effective utilization of healthcare services and ensuring regulatory compliance.

The position is 100% remote with a potential to support a fast-paced care team.

Qualifications

2–4 years of experience in a healthcare setting.
Proficient in MS Word and Excel.
Ability to navigate multiple systems and manage tasks efficiently.

Responsibilities

Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution.
Screen members using established guidelines and business rules to identify care needs and required services.
Initiate referrals to Case Management, Disease Management, LTSS, and other programs as appropriate.
Conduct outreach to members, providers, and care team partners to support care coordination efforts.
Document member information, outreach, and case activity accurately in internal systems.
Support development and implementation of member care plans under clinical staff guidance.
Coordinate healthcare services and identify in-network, cost-effective care options.
Perform non-clinical research to support case development, maintenance, and closure.
Communicate effectively with internal teams, providers, and members to facilitate care delivery.
Provide administrative and operational support, including call handling and issue resolution.
Maintain audit-ready documentation in compliance with policies and regulatory requirements.
Adhere to CMS, NCQA, URAC, and internal quality guidelines.