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Care Management Specialist

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Work at Home

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Category:
Customer Service

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Contract Type:
Not provided

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Salary:

21.10 - 40.90 USD / Hour
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Job Description:

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.

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
  • Additional Responsibilities: 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) and ability to effectively utilize these tools within the Care Manager Specialist role
  • Access to a private, dedicated space to conduct work effectively to meet the requirements of the position
  • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted

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
What we offer:
  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Bonus, commission or short-term incentive program

Additional Information:

Job Posted:
April 24, 2026

Expiration:
May 01, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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