Care Management Associate (CST/EST)

CVS Health•Carapichaima, TX

2d•$19 - $32•Remote

About The Position

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. Program Overview Join the Aetna Clinical Collaboration (ACC) team - an innovative and growing, community‑based care management model designed to transform how we serve our members. ACC utilizes best‑in‑class clinical and operating models to deliver meaningful, high‑impact care where it matters most. ACC is a member‑centric, team‑delivered approach that meets members where they are. Through compassionate engagement and strong communication, our care teams collaborate with members, providers, and community organizations to address the full continuum of healthcare needs, including medical, behavioral, and social determinants of health. This is an exciting opportunity to be part of a growing program with national expansion; offering the chance to help shape care delivery in new markets and have a life‑changing impact on the members we serve. Position Summary/Mission The Care Management Associate (CMA) supports the ACC Case Management team by performing non-clinical care coordination and administrative functions to promote timely, effective member care. Working under the direction of Senior Managers, the CMA assists with care coordination activities, telephonic outreach, and case support to ensure efficient care delivery and positive member outcomes.

Requirements

Candidate must reside in CST/EST time zones
1+ year(s) of customer service experience (healthcare environment preferred)
Strong customer service and member engagement skills
Strong organizational skills, including effective verbal and written communication skills
Basic knowledge of medical terminology
Proficiency in Microsoft Office (Word, Excel, Outlook) and ability to navigate multiple systems
Candidates must have a dedicated workspace free of interruptions
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted

Nice To Haves

2–4 years of healthcare experience (e.g., medical office, hospital, care coordination, billing/coding)
Experience supporting care management or case management teams
Familiarity with clinical platforms such as MedCompass or CEC

Responsibilities

Supports ACC team with daily care coordination and case support activities
Review and monitor daily census and providing to on-site staff via email
Perform inbound and outbound telephonic outreach to members, providers, and facilities
Process referrals, track cases, manage shared queues and program mailboxes
Enter and maintain accurate documentation in clinical systems (e.g., MedCompass, CEC)
Complete detailed documentation of all member interactions in compliance with regulatory and accreditation standards
Facilitate communication between interdisciplinary care team members and external stakeholders
Conduct non-clinical research and gather information to support care planning and case progression
Escalate clinical concerns or barriers to Senior Managers as appropriate