FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing healthcare enrollment and case management for child and family welfare populations, while effectively communicating with members and healthcare providers. Proficient in utilizing Aetna systems and MS Office Suite to maintain accurate documentation and support quality management processes.
Highest-signal resume keywords
Healthcare Enrollment ManagementCase Management ExperienceEffective Communication SkillsMS Office Suite ProficiencyCANS Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Member ReviewWellness Plan DevelopmentHealth Questionnaire AdministrationMedical-Service Needs ScreeningDocumentation AccuracyClaims Payment Issue ResolutionMultisystem NavigationOutbound CallingMotivational InterviewingPopulation Health Management
Soft Skills
Organizational SkillsCustomer Service SkillsAdaptabilityTeam CollaborationProblem-Solving Skills
Tools & Technologies
Aetna SystemsMS Office SuiteTelephonic Communication Tools
Certifications & Qualifications
CANS Certification
Industry Keywords
Managed CareChild WelfareFoster CareCommunity EngagementQuality Management
About the role
Key responsibilities & impact- Conduct initial member review and triage
- Manage population health enrollment for child and family welfare members
- Manage a low-tier member caseload
- Develop Wellness Plans and provide community resources
- Review gaps in care and administer health questionnaires
- Complete outbound calls and persistent outreach to engage members and community resources
- Screen members to identify medical-service needs and make referrals
- Identify triggers for Case Management, Disease Management, Mixed Services, and Specialty Program referrals
- Use Aetna systems to build, research, and enter member information
- Coordinate healthcare service delivery under nurse or medical director direction
- Promote communication with healthcare providers and care team members
- Perform non-medical research for open-case management
- Support team members by answering calls, researching information, and resolving problems
- Maintain accurate documentation meeting regulatory, risk-management, and accreditation requirements
- Protect member confidentiality
- Assist with claims payment issue research and resolution
- Support hospital care, case management, and quality management processes
- Meet daily metrics and deliverables
- Participate effectively in multidisciplinary teams
Requirements
What you’ll need- Must reside in Ohio, West Virginia, Kentucky, or Louisiana
- 2–4 years’ experience in healthcare or working with foster, child and family welfare populations
- Effective communication, telephonic, and organizational skills
- Ability to manage multiple priorities and adapt to change
- Strong customer service skills
- 2+ years’ proficiency with personal computers, keyboard, multi-system navigation, and MS Office Suite (Teams, Outlook, Word, Excel, etc.)
- Willingness to travel in-state 5–10% for meetings, community engagement, and training
- Reliable transportation
- Must pass the 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
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- Mileage reimbursement per company expense reimbursement policy