Care Management Associate

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Assess, prioritize, and categorize incoming tasks for the Care Team.

• Evaluate members according to established guidelines and business protocols to determine care requirements and necessary services.

• Start referrals to Case Management, Disease Management, LTSS, and various specialty programs.

• Conduct outreach to members, healthcare providers, and care team partners.

• Accurately and swiftly document member information, outreach efforts, and case activities in internal systems.

• Assist in the creation and execution of member care plans under the guidance of clinical staff.

• Coordinate healthcare services and identify in-network, cost-efficient care options.

• Perform non-clinical research to aid in case development, management, and closure.

• Communicate effectively with internal teams, providers, and members to enhance care delivery.

• Provide administrative and operational support, encompassing call handling, issue resolution, and task follow-up.

• Ensure documentation is accurate, complete, and ready for audits.

• Comply with CMS, NCQA, URAC, and internal quality and compliance standards.

⛳️ Requirements

• 2–4 years of experience in a healthcare environment (e.g., medical assistant, office assistant, care coordination support).

• Proficiency in computer skills, particularly with Microsoft Word and Excel.

• Capability to navigate multiple systems and efficiently manage tasks in a fast-paced setting.

• Strong verbal and written communication abilities, including phone outreach.

• Familiarity with basic medical terminology and care management principles.

• Exceptional organizational and time management skills with a keen attention to detail.

• Customer-oriented mindset with the ability to proactively resolve issues.

• Ability to work collaboratively within a multidisciplinary team.

• High School Diploma or GED is required.

• Must have a dedicated, distraction-free workspace.

• Reliable childcare or dependent care arrangements during work hours.

• Ability to handle a high-volume workload while meeting productivity and documentation standards.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• 100% remote work arrangement.