Care Mgt Associate

CVS Health

1d • $19 - $32

About The Position

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Training is 4 weeks, then 8 weeks with a preceptor. 8 hour shifts Start Times Available: 9:00am EST – 11am EST The Care Management Associate supports comprehensive coordination of medical services including Care team intake, screening, and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.

Requirements

• 2 years of experience in either customer service, telemarketing and/or sales
• Proficiency in typing for keying in information and navigating in multiple systems
• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel
• Requires long periods of sitting and telephone and computer work.

Nice To Haves

• Data entry and documentation within member records
• Medical office experience
• Call center experience
• Medical terminology knowledge
• Strong telephonic communication skills
• Strong organizational skills with an ability to prioritize tasks to meet time-sensitive deadlines
• Effective verbal and written communications skills with both customers and teammates

Responsibilities

• Responsible for initial review and triage of Care Team tasks.
• Identifies principal reason for admission, facility, and member product to correctly apply intervention assessment tools.
• Utilizes Aetna systems to build, research and enter member information, as needed.
• Supports the development and implementation of Care Plans.
• Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services
• Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively)
• Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases
• 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 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.
• May assist in the research and resolution of claims payment issues.
• Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees