Care Management Associate – Medicare Precertification, Home Care Team

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

📋 Description

• Evaluate and prioritize provider requests and member cases.

• Engage with members to verify the delivery of anticipated home care services and ensure adequate support.

• Raise identified issues to clinicians for necessary follow-up and intervention.

• Collaborate with healthcare providers, members, and internal teams to promote quality care outcomes.

• Investigate and address case-related issues while ensuring adherence to regulatory and corporate standards.

• Keep precise documentation.

• Offer administrative and customer support for operational needs.

• Assist members in transitioning from acute/post-acute care to home settings in conjunction with nurses, medical directors, providers, and care teams.

⛳️ Requirements

• Familiarity with basic medical terminology and healthcare concepts.

• Exceptional customer service and communication skills, including phone support.

• Experience in a Call Center setting is mandatory.

• Strong organizational and problem-solving skills.

• Proficient in Microsoft Office applications, particularly Word and Excel.

• Capability to work effectively in a collaborative, multidisciplinary environment.

• High School Diploma is a must.

• Availability to work Monday–Friday, from 8:30 am to 5:00 pm Eastern Time Zone.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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

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