CVS Health is hiring a Care Manager Specialist to join our mission of transforming health care. In this remote role based in Ohio, you will be a vital part of the Special Needs Plan (SNP) care team, coordinating care for members and focusing on social determinants of health and stable health conditions.
What You'll Do
- Dedicate 50-75% of your day to telephonic engagement with members and coordinating their care.
- Utilize all available resources to connect with and engage 'hard-to-reach' members.
- Partner with members to develop individualized care plans with specific goals and interventions.
- Maintain meticulous documentation of all care management activities in the member’s electronic health record.
- Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining stable health.
- Identify and connect members with appropriate health plan benefits and community resources.
- Meet all regulatory requirements within specified timelines.
- Consult with the Care Manager RN for clinical knowledge, medication regimes, and supportive clinical decision making.
- Collaborate and leverage the Care Manager RN's clinical expertise to ensure members’ needs are adequately addressed.
- Support team objectives, enhance operational efficiency, and ensure delivery of high-quality care to members.
What We're Looking For
- 2+ years of experience in a health-related field.
- 2+ years of customer service experience.
- Proficient in the Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).
- Access to a private, dedicated space to conduct work effectively.
- An Associate’s degree and relevant experience in a health care-related field.
Nice to Have
- 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 the care planning processes.
- Bilingual skills, especially English-Spanish.
- A Practical Nurse Degree/Certificate with active licensure that meets state requirements OR a bachelor’s degree in health care or a related field.
Technical Stack
- Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams)
Team & Environment
You will be a member of the Special Needs Plan (SNP) care team, collaborating closely with a Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants.
Benefits & Compensation
- Compensation range: $21.10 - $36.78 per hour
- Affordable medical plan options
- 401(k) plan with matching company contributions
- Employee stock purchase plan
- No-cost programs including wellness screenings, tobacco cessation, weight management, confidential counseling, and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
Work Mode
This is a fully remote position requiring residency in Ohio.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
