This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. As an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly those with social determinants of health (SDoH) needs and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants to support the member in maintaining optimal health. This is achieved by evaluating the members’ needs through the completion of the annual Health Risk Assessment Survey, addressing SDoH needs, and closing gaps in preventative and health maintenance care.
Job Responsibility:
Telephonic Engagement: Dedicate 50-75% of the day to engaging with members and coordinating their care
Member Outreach: Utilize all available resources to connect with and engage “hard-to-reach” members
Care Planning: Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs
Documentation: Maintain meticulous documentation of care management activities in the member’s electronic health record
Collaboration: Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition
Resource Connection: Identify and connect members with health plan benefits and community resources
Regulatory Compliance: Meet regulatory requirements within specified timelines
Consults with the Care Manager RN within the Care Team for clinical knowledge, medication regimes, and supportive clinical decision making
Collaborates and leverages the Care Manager RN clinical expertise to ensure members’ needs are adequately addressed
Support team objectives, enhance operational efficiency, and ensure delivery of high-quality care to members
Requirements:
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)
Access to a private, dedicated space to conduct work effectively
Associate’s degree with relevant experience in a health care-related field OR Practical Nurse degree/certificate with active state licensure
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
Bachelor’s degree in healthcare or a related field
What we offer:
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching