Care Management Associate
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Care Management Associate coordinating medical services, eligibility, referrals, and pre-certification cases for CVS Health members. Remote Texas role supporting case and utilization management teams.
Responsibilities:
- Support comprehensive coordination of medical services through intake and outgoing calls
- Work closely with case management and utilization management teams
- Review eligibility and benefits
- Open pre-certification cases and approve or send cases to nursing staff for review
- Evaluate patients using targeted intervention business rules and processes
- Identify needed medical services, make referrals, and coordinate services according to benefit plans
- Communicate health care service delivery based on nurse or medical director outcomes/reviews
- Perform non-medical research for establishing, maintaining, and closing open cases
- Answer provider and member telephone calls, take accurate messages, and support electronic transmission review and referrals
- Use internal tools to determine required steps for clinical review and plan guidelines
- Maintain accurate and complete documentation meeting risk management, regulatory, and accreditation requirements
- Enhance internal and external communication to improve medical management services
- Obtain discharge dates and make referrals to clinical teams for follow-up
- Work independently when needed while following department guidelines, policies, and procedures
- Meet quality and quantity performance standards in a rapidly changing environment
Requirements:
- 2 years’ experience as a medical assistant, office assistant or related experience
- Minimum of 6 months of call center experience required
- High School Diploma or equivalent GED
- Effective communication, telephonic and organization skills
- Familiarity with basic medical terminology and concepts used in care management
- Strong customer service skills
- Computer literacy, including Excel and Microsoft Word
- Ability to work shifts based on a Central Time schedule
- Ability to work the phone queue hours of 7 am–6 pm Central Time; ideally the 9:30 am–6 pm Central timeslot
Benefits:
- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being, based on eligibility
Similar Jobs
Candidate Outreach Associate Intern
Candidate Outreach Associate calling shortlisted candidates for Weekday’s startup hiring platform. Driving interview conversions through high-volume outreach, follow-ups, and ATS updates.
Study Start Up Associate
Study Start Up Associate launching clinical trials for ICON, a global healthcare intelligence and clinical research organisation. Managing site activation, essential documents, timelines, and eTMF accuracy.
Psychological Associate
Psychological Associate providing supervised assessment, diagnosis, treatment, and psychotherapy. Supporting PACC’s autism, behavioral health, and family services through individualized care.
Associate Toxicologist
Associate Toxicologist supporting NAMSA’s medical-device safety and biocompatibility consulting. Preparing regulatory assessments, reports, and client guidance for global healthcare products.
Associate Audit, Client Delivery – Incent, LatAm
Claims Analyst reviewing marketing materials, campaign expenses, and website functionality for ANSIRA clients. Ensuring compliance with program guidelines while communicating findings to marketers and customers.
Senior Associate
Workers’ compensation defense attorney managing cases from inception through litigation and resolution. Advising insurers, employers, and administrators for a women-owned California law firm.
Contract Associate
Contract Associate managing contract drafting, negotiation, lifecycle, and compliance for ICON’s global healthcare and clinical research organization.
Medical Information Associate, Dutch
Medical Information Associate handling Dutch and English medical inquiries and adverse-event reporting. Supporting PrimeVigilance’s global pharmacovigilance services that protect pharmaceutical patients.
Medical Information Associate, Dutch Language
Medical Information Associate handling Dutch and English medical inquiries for PrimeVigilance, a global pharmacovigilance specialist. Documenting adverse events and supporting regulatory inspections to protect patient safety.
Medical Information Associate – Dutch
Medical Information Associate supporting PrimeVigilance’s global pharmacovigilance services through Dutch and English medical inquiry handling. Documenting adverse events and supporting regulatory inspections.
Senior Document Production Associate
Senior Document Production Associate formatting complex legal documents, presentations, and reports for Williams Lea’s law-firm clients. Using advanced Microsoft Office and document-production expertise in a fully remote UK role.
Escalation Associate
Escalation Associate resolving complex customer concerns for Best Buy Canada’s tech retail operations. Investigating cases and coordinating with stores, distribution centers, care teams, and delivery partners.
Territory Coverage Associate
Territory Coverage Associate supporting Mondelēz snack-brand merchandising across Georgia markets. Covering store visits, promotional displays, and field execution for Oreo, Ritz, and Chips Ahoy.
Study Start Up Associate II
Study Start Up Associate leading clinical trial regulatory initiation for ICON’s global healthcare research organization. Managing submissions, approvals, and site activation across North American studies.
Associate Faculty – DNP Health Care Technology, Part Time
Associate Faculty teaching online graduate health care technology courses at University of Phoenix. Supporting student success through instruction, assessment, coaching, and mentorship.
Associate Faculty – DNP Project Chair, Part Time
Part-time virtual DNP Project Chair teaching and mentoring nursing students. Supporting evidence-based practice projects at University of Phoenix, a higher education institution.
M&A Associate
M&A Associate evaluating U.S. solar and storage acquisitions for a renewable energy company. Leading project valuation, diligence, financial modeling, and market analysis.
Sponsorship Fulfillment Associate
Sponsorship fulfillment associate coordinating sponsor campaigns, webinars, dinners, and conference deliverables. Supporting Pavilion’s global GTM professional community through reliable cross-functional execution.
Study Start Up Associate II
Study Start Up Associate leading regulatory submissions and site activation for ICON, a global healthcare intelligence and clinical research organisation. Coordinating approvals to accelerate new medicines to patients.
M&A Associate
M&A Associate valuing U.S. solar and storage projects for a renewable energy company. Supporting diligence, origination, market analysis, and acquisition negotiations.