Care Management Associate

CVS Health

. Support comprehensive coordination of medical services, including Care Team intake, screening, and care plan implementation .

Posted 10/28/2026full-timeRemote • Connecticut • United StatesJuniorMid-Level💰 $19 - $39 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating medical services, implementing care plans, and navigating healthcare systems while ensuring compliance with regulatory standards. Proficient in communication and collaboration with clinical teams and healthcare providers to deliver effective patient care.

Highest-signal resume keywords

Healthcare CoordinationMedical Billing And CodingMicrosoft Office 365 ApplicationsStrong Communication SkillsRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Plan ImplementationPatient ScreeningIntervention Assessment ToolsClaims Payment ResolutionMedical Terminology

Soft Skills

Outgoing PresencePositive AttitudeProblem-SolvingIndependent WorkTeam Collaboration

Tools & Technologies

Med CompassAetna SystemsEHR PortalsVPN AccessDigital Tools

Certifications & Qualifications

High School DiplomaG.E.D.

Industry Keywords

Healthcare FieldCase ManagementQuality ManagementURAC StandardsNCQA Standards

About the role

Key responsibilities & impact

Support comprehensive coordination of medical services, including Care Team intake, screening, and care plan implementation
Review and triage Care Team tasks
Identify admission reasons, facilities, and member products to apply intervention assessment tools
Screen patients using targeted intervention rules and processes to identify needed medical services
Refer patients to medical services staff and coordinate services according to the benefit plan
Monitor non-targeted cases for discharge dates and dispositions
Identify outlier cases and triggers for referral to Aetna Case Management, Mixed Services, and Specialty Programs
Use Med Compass and Aetna systems to build, research, and enter member information
Support development and implementation of care plans
Coordinate healthcare service delivery under nurse or medical direction and identify participating providers and cost-effective services
Promote internal and external communication with healthcare providers and team members
Perform non-medical research for establishing, maintaining, and closing open cases
Provide support services to team members
Assist with researching and resolving claims payment issues
Support hospital care, case management, and quality management processes in compliance with laws, regulations, URAQ, NCQA, CMSA standards, and company policies
Complete training Monday through Friday, 40 hours per week, for approximately 4-8 weeks during 8:00 AM-8:00 PM ET
Work the weekend schedule Saturday-Tuesday, 7:00 AM-5:30 PM in the respective time zone, totaling four 10-hour days

Requirements

What you’ll need

2-4 years of experience within the healthcare field, medical/health setting, medical billing, and coding
Experience in a call center or customer service environment
Ability to work independently, meet deliverables and deadlines, and demonstrate an outgoing, enthusiastic and caring presence telephonically
Ability to meet daily metrics with speed and accuracy and maintain a positive attitude
Strong written and oral communication skills
Ability to work efficiently across multiple systems simultaneously, including Microsoft Office 365 applications, clinical platforms, and health plan systems
Technical proficiency navigating computer systems and digital tools
Ability to work independently while collaborating effectively with clinical teams
Excellent communication skills for interacting with providers and internal stakeholders
High School Diploma or G.E.D.
Ability to obtain a direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds 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
Must provide own workspace furniture suitable for extended desk work
Ability to use multiple monitors and applications simultaneously
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace tools
Ability to access secure systems such as VPN and EHR portals, follow computer security practices, and recognize suspicious emails or links
Ability to troubleshoot common technical issues independently
Weekend and holiday availability
Knowledge of medical terminology preferred
Ability to research information and assist in solving problems preferred
Compliance with PM policies and regulatory standards preferred
Ability to maintain accurate documentation meeting risk management, regulatory, and accreditation requirements preferred
Ability to protect confidential member information preferred
Ability to handle multiple assignments accurately and efficiently 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 supporting physical, emotional, and financial well-being
Company-provided equipment (keyboard, monitor, computer, headset, etc.)