Care Management Associate

CVS Health Careers

. Evaluate patients using targeted intervention business rules and processes .

Posted 11/3/2026full-timeRemote • Arizona • United StatesJuniorMid-Level💰 $19 - $35 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates proficiency in patient evaluation, care coordination, and effective communication within healthcare settings. Capable of utilizing internal systems for documentation and compliance while maintaining member confidentiality and adhering to regulatory standards.

Highest-signal resume keywords

Patient EvaluationCare CoordinationMicrosoft Office 365Telephonic CommunicationMedical Terminology

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Typing ProficiencyData EntryDocumentationTechnical TroubleshootingInternet Connection Setup

Soft Skills

Organizational SkillsEffective CommunicationCritical ThinkingProblem-SolvingTime Management

Tools & Technologies

Microsoft WordMicrosoft OutlookMicrosoft ExcelVPN AccessEHR Portals

Industry Keywords

HIPAA ComplianceCase ManagementQuality ManagementRisk ManagementTelemarketing Experience

About the role

Key responsibilities & impact

Evaluate patients using targeted intervention business rules and processes
Identify needed medical services and make appropriate referrals
Coordinate required services according to the benefit plan
Communicate health care service delivery based on nurse or medical director reviews
Perform non-medical research for establishing, maintaining, and closing open cases
Answer provider and member telephone calls and take accurate messages
Support electronic transmission review and referrals
Use internal tools to determine required review steps based on clinical requirements and plan guidelines
Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements
Promote internal and external communication to improve medical management services
Obtain discharge dates and make referrals to the clinical team for follow-up
Perform initial review and triage of Care Team tasks
Identify admission reason, facility, and member product to apply intervention assessment tools
Use Aetna systems to build, research, and enter member information
Support development and implementation of care plans
Coordinate health care delivery under nurse or medical director direction in appropriate settings and at appropriate expense
Assist with research and resolution of claims payment issues
Support hospital care, case management, and quality management processes in compliance with applicable standards, laws, regulations, and company procedures
Protect member confidentiality
Complete work independently using judgment and critical thinking while meeting quality and productivity standards

Requirements

What you’ll need

2 years of experience in customer service, telemarketing and/or sales
Proficiency in typing and navigating multiple systems
Computer experience, including Microsoft Word, Outlook, and Excel
High School diploma or equivalent GED
Must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
WiFi and satellite internet are not permitted
Quiet, secure, private, designated home work location compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Ability to use multiple monitors and navigate multiple applications simultaneously
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar Google Workspace applications
Ability to access secure systems such as VPN and EHR portals
Ability to follow computer and information-security practices
Ability to troubleshoot common technical issues independently
Requires long periods of sitting and telephone and computer work
Preferred: data entry and documentation within member records
Preferred: medical office experience
Preferred: call center experience
Preferred: medical terminology knowledge
Preferred: strong telephonic communication skills
Preferred: strong organizational skills and ability to prioritize time-sensitive tasks
Preferred: effective verbal and written communication skills
In the requisition details: high school diploma or 5+ years equivalent experience; 5+ years prior relevant work experience; adept problem-solving and decision-making skills

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 supporting physical, emotional, and financial well-being
Company-provided equipment (keyboard, monitor, computer, headset, etc.)