Care Management Associate Member Connections Eastern Time Zone

CVS Health•Work At Home-Kansas, CT

1d•$19 - $42

About The Position

Aetna’s Medicaid Care Management Engagement Outreach Hub is a dedicated team focused on increasing interaction with Medicaid members and using inbound and outbound outreach to address member needs and support behavioral change. The Care Management Associate supports comprehensive healthcare coordination by making telephonic outreach to eligible members, enrolling them in care management, facilitating case assignment, and connecting identified members with care managers through warm transfers. The role combines member engagement, healthcare navigation, and health plan customer support to promote effective use of healthcare services and quality outcomes. The Associate also supports team members by answering calls, taking messages, researching information, and helping resolve problems. The role requires compliance with policies, procedures, and regulatory standards; complete and accurate documentation that meets risk management, regulatory, and accreditation requirements; and protection of confidential member information. The position must be based in the Eastern Time Zone.

Requirements

Effective communication, telephone, and organizational skills, with the ability to manage multiple priorities and adapt to change.
Ability to meet daily metrics with speed, accuracy, and a positive attitude.
Strong customer service skills, including attentiveness to customers, sensitivity to issues, and proactive identification and resolution of issues.
Ability to complete detailed documentation efficiently and meet compliance requirements.
Ability to work independently, meet deliverables and deadlines, and present an outgoing, enthusiastic, and caring presence by telephone.
Ability to participate effectively in a multidisciplinary team with internal and external participants.
High school diploma plus experience.
Must sit in the Eastern Time Zone.

Nice To Haves

Two to four years of healthcare experience, such as in a medical office, hospital, or medical billing or coding setting.
Computer experience, including Microsoft Word, Outlook, and Excel, and data entry and documentation in member records.
Familiarity with basic medical terminology and care management concepts.
Flexibility to work occasional nights and weekends outside standard business hours, which can span from 8:00 a.m. to 8:00 p.m.
Strong organizational skills and effective verbal and written communication skills.
Spanish bilingual proficiency.

Responsibilities

Conduct telephonic outreach to eligible members and support their enrollment in care management.
Engage members, facilitate case assignment, and connect identified members to care managers through warm transfers.
Support implementation of care plans and promote effective utilization of healthcare services and quality outcomes.
Answer telephone calls, take messages, research information, and assist team members in solving problems.
Document each member call and complete required actions accurately and thoroughly in the electronic record.
Follow care management processes, company policies and procedures, and applicable compliance, regulatory, and accreditation requirements.
Protect the confidentiality of member information.