Care Management Associate

CVS Health Careers

. Perform initial review and triage of members .

Posted 11/5/2026full-timeRemote • United StatesJuniorMid-Level💰 $19 - $35 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing healthcare service delivery for child and family welfare populations, including developing Wellness Plans and coordinating community resources. Proficient in utilizing Aetna systems and MS Office Suite applications to maintain accurate documentation and meet regulatory requirements.

Highest-signal resume keywords

Healthcare ExperienceWellness Plan DevelopmentAetna Systems ProficiencyCANS CertificationCustomer Service Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Population Health ManagementCare Gap ReviewMedical Service ReferralElectronic Records ManagementTelephonic CommunicationMulti-System NavigationMS Office Suite ProficiencyDocumentation AccuracyClaims ResolutionMotivational Interviewing

Soft Skills

Effective CommunicationOrganizational SkillsProblem ResolutionAdaptabilityTeam Collaboration

Tools & Technologies

Aetna SystemsMS TeamsMS OutlookMS WordMS Excel

Certifications & Qualifications

CANS Certification

Industry Keywords

Managed CareChild WelfareFamily WelfareHealthcare DeliveryCall Center Experience

About the role

Key responsibilities & impact

Perform initial review and triage of members
Manage population health member enrollment for child and family welfare populations
Manage a low-tier member caseload
Develop Wellness Plans and provide community resources
Review gaps in care and administer health questionnaires
Complete outbound calls to identify and engage appropriate community resources
Screen members using intervention rules and processes to identify needed medical services
Make referrals to medical services staff and coordinate required services according to the benefit plan
Identify triggers for referral into Case Management, Disease Management, Mixed Services, and other Specialty Programs
Use Aetna systems to build, research, and enter member information
Coordinate healthcare service delivery under the direction of a nurse or medical director
Promote communication with healthcare providers and healthcare team members
Perform non-medical research for establishing, maintaining, and closing open cases
Support team members by answering calls, researching information, and assisting with problem resolution
Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements
Protect member confidentiality
Assist with research and resolution of claims payment issues
Complete detailed electronic records for each member call
Meet daily metrics and deliverables while working independently
Participate in multidisciplinary teams
Conduct persistent outreach and promote active connection

Requirements

What you’ll need

Must reside in Ohio, West Virginia, Kentucky, or Louisiana
2-4 years’ experience in healthcare field or working with foster, child and family welfare populations
Effective communication, telephonic and organization skills; ability to manage multiple priorities and adapt to change
Strong customer service skills
2+ years’ demonstrated proficiency with personal computers, keyboard, multi-system navigation, and MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)
Some in-state travel (5-10%) may be required; must possess reliable transportation and be willing to travel
Must pass CANS certification exam within the first 3 months of employment
High school diploma or G.E.D.
Motivational interviewing skills preferred
Call Center experience preferred
Managed Care experience preferred

Benefits

Comp & perks

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 based on eligibility
Mileage reimbursement per company expense reimbursement policy
Flexible work schedule may be available after 6 months of service and demonstrated performance and attendance