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Care Management Associate
$38,480 - $65,978/Yr
CVS Health - Phoenix, AZ
posted 2 months ago
Full-time - Entry Level
Remote - Phoenix, AZ
10,001+ employees
Health and Personal Care Retailers
About the position
The Care Management Associate (CMA) position at CVS Health is a fully remote role focused on supporting the coordination of medical services. The CMA will handle intake and outgoing calls, review eligibility and benefits, and manage pre-certification cases. This role involves working closely with both case management and utilization management teams to ensure effective service delivery and compliance with regulatory standards.
Responsibilities
- Support comprehensive coordination of medical services including intake and outgoing calls.
- Review eligibility and benefits and open pre-certification cases.
- Perform initial review and triage of Care Team tasks.
- Identify principal reasons for admission and apply intervention assessment tools.
- Screen patients to identify needed medical services and make appropriate referrals.
- Monitor non-targeted cases for discharge dates and dispositions.
- Identify and refer outlier cases to clinical staff.
- Utilize Aetna systems to build, research, and enter member information.
- Support the development and implementation of care plans.
- Coordinate health care service delivery under the direction of a nurse or medical director.
- Promote communication to enhance effectiveness of medical management services.
- Maintain accurate documentation to meet risk management and regulatory requirements.
- Protect confidentiality of member information and adhere to company policies.
- Assist in the research and resolution of claims payment issues.
Requirements
- 2 years' experience as a medical assistant, office assistant, or related experience.
- Minimum of 6 months of call center experience.
Nice-to-haves
- Effective communication skills
- Telephonic skills
- Organizational skills
- Familiarity with basic medical terminology
- Strong customer service skills
- Computer literacy including Excel and Microsoft Word.
Benefits
- 401(k)
- Dental insurance
- Disability insurance
- Employee discount
- Employee stock purchase plan
- Health insurance
- Life insurance
- Paid Time Off (PTO)
- Paid holidays
- Short-term and long-term disability benefits
- Well-being programs
- Education assistance
- Free development courses
