Care Management Specialist

CVS Health

. Engage telephonically with members for 50–75% of the workday .

Posted 9/24/2026full-timeRemote • United StatesJuniorMid-Level💰 $21 - $41 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for Special Needs Plan members, with a strong focus on social determinants of health and chronic conditions. Proficient in utilizing healthcare technology and Microsoft Office Suite to enhance operational efficiency and member engagement.

Highest-signal resume keywords

Care Management ExperienceHealth Risk AssessmentMicrosoft Office ProficiencyMedicare and Medicaid KnowledgeBilingual Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care CoordinationHealth Risk Assessment SurveysIndividualized Care PlansElectronic Health Records DocumentationHealthcare Technology Utilization

Soft Skills

Effective CommunicationCustomer Service SkillsTeam CollaborationMentoring Abilities

Tools & Technologies

Microsoft Office SuiteElectronic Health Records

Certifications & Qualifications

Associate’s Degree in Health Care-Related Field

Industry Keywords

Social Determinants of HealthChronic Medical ConditionsBehavioral HealthCommunity ResourcesMedicareMedicaid

About the role

Key responsibilities & impact

Engage telephonically with members for 50–75% of the workday
Coordinate care for Special Needs Plan members, particularly those with social determinants of health needs and stable health conditions
Complete annual Health Risk Assessment Surveys
Conduct member outreach using available resources
Develop individualized care plans with members
Document care management activities in electronic health records
Collaborate with the Interdisciplinary Care Team to address barriers to care
Connect members with health plan benefits and community resources
Meet regulatory requirements within specified timelines
Consult with and leverage the Care Manager RN’s clinical expertise
Support team objectives and operational efficiency
Participate in special projects and process improvement initiatives
Assist with mentoring new team members

Requirements

What you’ll need

2+ years of experience in a health-related field
2+ years of customer service experience
Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams)
Ability to effectively utilize Microsoft Office tools within the Care Manager Specialist role
Access to a private, dedicated space to conduct work effectively
Dependents must have separate care arrangements during work hours
Associate’s Degree AND relevant experience in a health care-related field (REQUIRED)
Experience or willingness to thoroughly learn care management within Medicare and Medicaid managed care
Familiarity with community resources and services
Ability to navigate and utilize healthcare technology tools
Ability to meet performance and productivity metrics
Effective verbal and written communication
Excellent customer service and engagement skills
Preferred: Experience providing care management for Medicare and/or Medicaid members
Preferred: Experience with individuals with SDoH needs, chronic medical conditions, and/or behavioral health
Preferred: Experience conducting health-related assessments and facilitating care planning
Preferred: Bilingual skills, especially English-Spanish

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