Case Manager Assistant (Mercy Care - Arizona)

CVS Health

2d • $19 - $35 • 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. Position Summary The Case Manager Assistant is a work from home opportunity, supporting Case Managers with comprehensive coordination of services and follow up support to ALTCS (Arizona Long Term Care System) membership. What you will do: Outreach to members and providers for care coordination. Make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. Utilize Dynamo, QNXT, and other Aetna systems to build, research, and enter member information as needed. Coordinate and arrange for health care service delivery under the direction of the case manager (in the most appropriate setting, at the most appropriate expense) by identifying opportunities for the ALTCS member to utilize participating providers and services. Promote communication, both internally and externally, to enhance effectiveness of service delivery. Perform non-medical research pertinent to the establishment, maintenance, and closure of open cases. Provide support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems. Adhere to compliance with AHCCCS (Arizona Health Care Cost Containment System) AM/PM (AHCCCS Medical Policy Manual) and Regulatory Standards. Maintain accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Protect the confidentiality of member information and adhere to company policies regarding confidentiality. Support the case manager with post hospital follow-up and placement changes. Comfortable with long periods of sitting, as well as telephonic and computer work. Perform other duties as needed.

Requirements

• 2+ years of experience in healthcare, as well as customer service, telemarketing, and/or sales.
• 1+ years of experience with computers, including knowledge of Microsoft Word, Outlook, Teams and Excel.
• Must reside in Arizona.
• Willingness to travel up to 10% of time within Maricopa, Pima, Pinal, and Gila Counties.

Nice To Haves

• 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.
• Experience with data entry and documentation within member records.
• Proficiency in typing for keying in information and navigating in multiple systems.
• Ability to work independently with remote support.
• Excellent attendance record.
• Experience working with people who have been designated as having a serious mental illness (SMI) and working with people who are elderly or have a physical disability.
• Experience collaborating with medical professionals.
• Knowledge of ALTCS (Arizona Long Term Care System).
• Medical office experience and/or medical terminology knowledge.

Responsibilities

• Outreach to members and providers for care coordination.
• Make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
• Utilize Dynamo, QNXT, and other Aetna systems to build, research, and enter member information as needed.
• Coordinate and arrange for health care service delivery under the direction of the case manager (in the most appropriate setting, at the most appropriate expense) by identifying opportunities for the ALTCS member to utilize participating providers and services.
• Promote communication, both internally and externally, to enhance effectiveness of service delivery.
• Perform non-medical research pertinent to the establishment, maintenance, and closure of open cases.
• Provide support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems.
• Adhere to compliance with AHCCCS (Arizona Health Care Cost Containment System) AM/PM (AHCCCS Medical Policy Manual) and Regulatory Standards.
• Maintain accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protect the confidentiality of member information and adhere to company policies regarding confidentiality.
• Support the case manager with post hospital follow-up and placement changes.
• Comfortable with long periods of sitting, as well as telephonic and computer work.
• Perform other duties as needed.

Benefits

• This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
• The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
• Additional details about available benefits are provided during the application process and on Benefits Moments.

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