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CVS Health

Care Management Associate

CVS Health

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

Posted 10/6/2026full-timeRemote • Texas • United StatesJuniorMid-Level💰 $19 - $35 per hourWebsite

Core Competencies

Role fit
Core 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

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Applicant 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