Care Management Specialist

CVS Health

. Coordinate care for Special Needs Plan members, particularly those with social determinants of health needs and stable health conditions .

Posted 9/28/2026full-timeRemote • United StatesJuniorMid-Level💰 $21 - $41 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in care management for Special Needs Plan members, focusing on social determinants of health and chronic conditions. Proficient in developing individualized care plans and collaborating with interdisciplinary teams to enhance member engagement and operational efficiency.

Highest-signal resume keywords

Care Management ExperienceHealth Risk AssessmentMicrosoft Office ProficiencyBilingual Skills (English-Spanish)Experience with Medicare/Medicaid

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills

Care ManagementHealth Risk AssessmentChronic Condition ManagementSocial Determinants of Health (SDoH)Care PlanningHealth Record DocumentationRegulatory ComplianceCustomer ServiceTelephonic EngagementOutreach Strategies

Soft Skills

CollaborationMentoringCommunicationProblem-SolvingOperational Efficiency

Tools & Technologies

Microsoft Office SuiteElectronic Health Records

Certifications & Qualifications

Associate’s Degree in Health CarePractical Nurse Degree/Certificate

Industry Keywords

Special Needs PlanMedicareMedicaidHealth CareCare Manager

About the role

Key responsibilities & impact

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 and address social determinants of health needs
Close gaps in preventive and health maintenance care
Engage members telephonically for 50–75% of the day
Conduct outreach to hard-to-reach members
Develop individualized care plans with members
Document care management activities in members’ 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, operational efficiency, special projects, process improvement, and mentoring of 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 with relevant experience in a health care-related field OR Practical Nurse Degree/Certificate with active licensure that meets state requirements (REQUIRED)
Experience providing care management for Medicare and/or Medicaid members
Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health
Experience conducting health-related assessments and facilitating care planning processes
Bilingual skills, especially English-Spanish (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