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by Chris Durst Feb. 19, 2025
| As we write, this job listing is online and applications appear to be open. But jobs can fill at any time, so apply or share quickly if you’re interested! Sorry, but we have no role in the HR processes of other companies. If you encounter difficulties in the application process please contact them directly. Good luck in your hunt, and may you be working from home soon! |
CVS has posted a Remote Care Management Associate job to their careers page.
UPDATE: As feared, this one filled quickly. It looks like the company received all the applications it needed and has deleted the job listing. For more jobs like this, see our Daily Jobs & Gigs page. To be the first to hear about jobs like these, join our free Telegram channel!
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This position is fully remote and employees can work from any state.
In this role, you will support the comprehensive coordination of medical services that include intake and outgoing calls for medical services. You will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review.
While this may sound like a highly-specialized role, the requirements are as follows:
Required Qualifications:
- Minimum of 6 months of customer service experience required.
Preferred Qualifications:
- Effective communication, telephonic and organization skills.
- Familiarity with basic medical terminology and concepts used in care management.
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification, and resolution of issues to promote positive outcomes for members.
- Computer literacy to navigate through Internal/external computer systems, including Excel and Microsoft Word.
Education:
- High School Diploma or equivalent experience
The posted pay rate is $18.50 – $35.29 per hour, and CVS offers a comprehensive benefits program.
Following are excerpts from the Remote Care Management Associate job posting:
This position is fully remote and employees can work from any state.
Normal Working Hours: 5 days a week (may include Saturday) shift time of 11:30am-8:00pm EST.
The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management team and utilization management team.
The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review.
The Care Management Associate role includes:
- 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.
- Screen patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
- Monitors non-targeted cases for entry of appropriate discharge date and disposition.
- Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff.
- Identifies triggers for referral into Aetna’s Case Management, Disease Management, Mixed Services, and other Specialty Programs.
- Utilizes Aetna systems to build, research and enter member information, as needed.
- Support 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 PM 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.
Required Qualifications:
- Minimum of 6 months of customer service experience required.
Preferred Qualifications:
- Effective communication, telephonic and organization skills.
- Familiarity with basic medical terminology and concepts used in care management.
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification, and resolution of issues to promote positive outcomes for members.
- Computer literacy to navigate through Internal/external computer systems, including Excel and Microsoft Word.
Education:
- High School Diploma or equivalent experience
Anticipated Weekly Hours: 40
Time Type: Full time
Compensation & Benefits
The typical pay range for this role is: $18.50 – $35.29
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
HOW TO APPLY
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CLICK HERE for full details and to apply for this Remote Care Management Associate position. For more jobs like this, check our Newest Jobs & Gigs page. To be the first to hear about jobs like these, join our free Telegram channel. Good luck as you make your work from home plans a reality!
