Care Management Associate Engagement Hub

CVS Health•Work At Home-Texas, TX

2d•$19 - $42•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. Aetna’s Medicaid Care Management Engagement Outreach Hub 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 Hub’s efficiency and productivity efforts whereby the Care Management Associates interact and engage telephonically with members. Through the successful supports orchestrated by the Hub 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 Engagement Outreach Hub 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.

Requirements

Strong communication, organizational, and customer service skills.
Ability to manage multiple priorities and adapt to change.
Consistently meet productivity and quality metrics with accuracy and a positive attitude.
Strong attention to detail and documentation skills.
Ability to work independently while collaborating effectively with team members.
Professional, enthusiastic, and member-focused approach to outreach.

Nice To Haves

2 to 4 years of healthcare experience (medical office, hospital, billing/coding, etc.).
Proficiency in Microsoft Word, Outlook, and Excel.
Familiarity with medical terminology and care management concepts.
Flexibility to work occasional evenings or weekends.
Strong verbal and written communication skills.
Bilingual Spanish preferred.

Responsibilities

Supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of eligible members.
Responsible for direct member outreach and engagement.
Facilitates case assignment.
Connects identified members to care managers immediately through a warm transfer.
Supports the implementation of care plans to promote effective utilization of healthcare services.
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.