Care Management Associate

hace 2 semanas


Mayagüez, Mayagüez, Puerto Rico Cvs Health A tiempo completo
Job Summary

Cvs Health is seeking a highly motivated and detail-oriented Care Management Associate to join our team. As a Care Management Associate, you will play a critical role in managing enrollment for Children's Specialty (CS) program, including foster, child and family welfare population health members and other programs serving children with special healthcare needs.

Key Responsibilities
  • Manage population health member enrollment for child and family welfare.
  • Develop and implement wellness plans to promote effective utilization of healthcare services.
  • Coordinate and arrange for healthcare service delivery under the direction of a nurse or medical director.
  • Identify triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs.
  • Utilize Aetna systems to build, research, and enter member information, as needed.
  • Support the development and implementation of wellness plans.
  • Promote communication, both internally and externally, to enhance the effectiveness of medical management services.
  • Perform non-medical research pertinent to the establishment, maintenance, and closure of open cases.
  • Provide support services to team members by answering telephone calls, researching information, and assisting in solving problems.
Requirements
  • Must reside in Ohio.
  • 2-4 years' experience in the healthcare field or working with foster, child and family welfare populations.
  • Effective communication, telephonic, and organization skills with the ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.
  • Strong customer service skills to coordinate service delivery, including attention to customers, sensitivity to issues, proactive identification, and resolution of issues to promote positive outcomes for members.
  • 2+ years' demonstrated proficiency with personal computers, keyboard, and multi-system navigation, and MS Office Suite application (Teams, Outlook, Word, Excel, etc.).
Preferred Qualifications
  • Motivational interviewing skills.
  • Call Center experience.
  • Managed Care experience.
About Cvs Health

Cvs Health is a leading healthcare company that puts its heart into caring for its colleagues and communities. We offer a range of benefits, including medical, dental, and vision benefits, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also provide a fully-paid term life insurance plan to eligible employees and short-term and long-term disability benefits. Our company culture values diversity, equity, and inclusion, and we are committed to creating a workplace that is welcoming and inclusive for all employees.


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