Case Manager Associate

CVS Health

. Review and triage Care Team tasks .

Posted 10/30/2026full-timeRemote • Virginia • 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 healthcare service delivery, utilizing intervention assessment tools, and maintaining compliance with regulatory standards. Proficient in managing patient information and supporting care plans while ensuring member confidentiality and effective communication with healthcare teams.

Highest-signal resume keywords

Healthcare CoordinationRegulatory ComplianceCustomer Service SkillsMicrosoft Office 365 ProficiencyCase Management Support

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

Intervention Assessment ToolsPatient ScreeningDocumentation ManagementClaims ResolutionEHR Portal Navigation

Soft Skills

Problem SolvingCommunicationTeam SupportAdaptabilityCustomer Service

Tools & Technologies

ETUMSMicrosoft OutlookMicrosoft WordMicrosoft ExcelVPN Access

Industry Keywords

HIPAA ComplianceNCQA StandardsCMSA StandardsURAC ComplianceHealthcare Services

About the role

Key responsibilities & impact

Review and triage Care Team tasks
Identify admission reasons, facilities, and member products to apply intervention assessment tools
Screen patients using intervention business rules and processes
Refer patients to medical services staff and coordinate required services according to benefit plans
Monitor non-targeted cases for discharge dates and dispositions
Identify outlier cases and refer them to clinical staff
Identify triggers for referral to Case Management, Disease Management, Mixed Services, and Specialty Programs
Use eTUMS and other Aetna systems to build, research, and enter member information
Support development and implementation of care plans
Coordinate and arrange healthcare service delivery under nurse or medical director direction
Promote communication with healthcare providers and healthcare team members
Perform non-medical research for establishing, maintaining, and closing cases
Support team members by answering calls, taking messages, researching information, and solving problems
Maintain compliance with PM policies and regulatory standards
Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements
Protect member confidentiality
Assist with research and resolution of claims payment issues
Support hospital care, case management, and quality management processes in compliance with applicable laws, regulations, URAQ, NCQA, and CMSA standards

Requirements

What you’ll need

Minimum of 1-3+ years experience as a medical assistant, office assistant, or related healthcare/medical role required
Strong customer service skills to coordinate service delivery
1-3 years of end user experience with Microsoft Outlook, Word, and Excel
High School diploma, G.E.D. or equivalent experience
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
WiFi and satellite internet are not permitted
Quiet, secure and private designated home virtual work location compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Ability to use multiple monitors and navigate multiple 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 log in to secure systems such as VPN and EHR portals
Ability to follow computer security practices, including strong passwords and recognizing suspicious emails or links
Ability to resolve common technical issues independently
Openness to learning new skills as the workplace environment evolves

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.)