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Care Management Associate
CVS Health. Support comprehensive coordination of medical services through intake and outgoing calls .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in coordinating medical services, including eligibility review, pre-certification processes, and effective communication with healthcare providers. Proficient in maintaining documentation that meets regulatory and accreditation standards while delivering strong customer service in a call center environment.
Highest-signal resume keywords
Medical Terminology FamiliarityCall Center ExperienceCustomer Service SkillsDocumentation AccuracyCommunication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Eligibility ReviewPre-Certification ProcessesCase Management SupportMedical Service CoordinationNon-Medical Research
Soft Skills
Effective CommunicationOrganizational SkillsTelephonic Skills
Tools & Technologies
Microsoft ExcelMicrosoft Word
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Healthcare CoordinationRisk ManagementRegulatory ComplianceAccreditation StandardsCare Management
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 or refer cases to nursing staff for review
- Evaluate patients using targeted intervention business rules and processes
- Identify needed medical services, make referrals, and coordinate services according to benefit plans
- 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, take accurate messages, and support electronic transmission review and referrals
- Use internal tools to determine required steps based on clinical requirements and plan guidelines
- Maintain accurate 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 referrals to clinical teams for additional follow-up
- Complete work independently 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; preferred 9:30am–6pm Central timeslot
Benefits
Comp & perks- Medical coverage
- Dental coverage
- 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