Care Management Associate

CVS Health

. Review, intake, screen, and triage Utilization Management and Care Management work .

Posted 11/10/2026full-timeRemote • United StatesJuniorMid-Level💰 $19 - $39 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Utilization Management and Care Management processes, with a strong focus on data accuracy, compliance with HIPAA regulations, and effective communication with clinical partners. Proven ability to manage multiple systems and meet productivity and quality expectations in a healthcare environment.

Highest-signal resume keywords

Utilization ManagementCare ManagementHIPAA ComplianceData AccuracyHealthcare Operations

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Case ManagementPrior AuthorizationDocumentation ManagementResearch SkillsWorkflow Adherence

Soft Skills

Attention to DetailTime ManagementAdaptabilityEffective Communication

Tools & Technologies

Provider PortalsHealthcare SystemsData Management Tools

Industry Keywords

PHIPIIRegulatory ComplianceAccreditationHealthcare Environment

About the role

Key responsibilities & impact

Review, intake, screen, and triage Utilization Management and Care Management work
Gather, research, and validate member, provider, facility, admission, authorization, and other case information
Prepare cases and route work to nurses, medical directors, and other clinical partners
Conduct outbound outreach to providers and facilities
Monitor work for missing information, discharge information, documentation needs, or follow-up conditions
Identify triggers for referrals or handoffs to Care Management, Disease Management, Transition of Care, and other clinical programs
Document calls, actions, research, outcomes, and follow-up activities in designated systems
Navigate multiple systems, work queues, provider portals, and technology tools while maintaining data accuracy
Perform non-clinical research to establish, maintain, process, and close cases
Manage assigned work within turnaround times and escalate barriers or aging work
Meet productivity and quality expectations while supporting positive experiences for members, providers, and internal partners
Protect PHI/PII and comply with applicable requirements

Requirements

What you’ll need

2+ years of experience in health insurance, healthcare operations, provider services, medical office operations, Utilization Management/Care Management support, prior authorization, or a comparable healthcare environment
High school diploma or GED
Strong attention to detail
Effective time management
Ability to work across multiple systems, applications, and work queues
Ability to follow established workflows and business rules
Ability to adapt to changing processes and technology
Ability to meet turnaround time, productivity, quality, and documentation expectations
Ability to protect PHI/PII and comply with HIPAA, privacy, security, regulatory, accreditation, and company requirements
Associate degree or higher in healthcare, business, or a related field (preferred)

Benefits

Comp & perks

Comprehensive medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program eligibility