Care Management Associate

CVS Health

. Support comprehensive coordination of medical services through intake and outgoing calls .

Posted 11/6/2026full-timeRemote • Texas • United StatesJuniorMid-Level💰 $19 - $35 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating medical services, including eligibility review, pre-certification processes, and effective communication with healthcare providers. Proficient in utilizing internal tools for case management while maintaining compliance with regulatory and accreditation standards.

Highest-signal resume keywords

Medical Terminology FamiliarityCall Center ExperienceCustomer Service SkillsDocumentation AccuracyCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementEligibility ReviewPre-Certification ProcessesCritical ThinkingTelephonic Communication

Soft Skills

Organization SkillsJudgment

Tools & Technologies

Microsoft ExcelMicrosoft Word

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Healthcare CoordinationRisk ManagementRegulatory ComplianceAccreditation StandardsPatient Referrals

About the role

Key responsibilities & impact

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 them or send them to nursing staff for review
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 outcomes and 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 as appropriate
Use internal tools to determine required steps for review based on clinical requirements and plan guidelines
Maintain accurate and complete documentation meeting risk management, regulatory, and accreditation requirements
Communicate internally and externally with health care providers and health care team members
Obtain discharge dates and make appropriate referrals to clinical teams for follow-up
Work independently when needed using judgment and critical thinking while following department guidelines, policies, and procedures
Meet quality and quantity performance standards in a rapidly changing environment

Requirements

What you’ll need

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 anticipated 9:30am–6pm Central timeslot ideally

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, based on eligibility