Care Management Specialist

This is a fully remote position, open to applicants in Connecticut, +11 more states.

📋 Description

• Communicate with members via telephone for 50–75% of the day to coordinate their care.

• Perform annual Health Risk Assessment Surveys.

• Address social determinants of health needs and bridge gaps in preventive and health maintenance care.

• Conduct outreach to members who are hard to reach using available resources.

• Create personalized care plans in collaboration with members.

• Record care management activities in members’ electronic health records.

• Work alongside the Interdisciplinary Care Team to overcome barriers to care.

• Identify and connect members with health plan benefits and community resources.

• Ensure compliance with regulatory requirements within designated timelines.

• Consult with and utilize the clinical expertise of the Care Manager RN.

• Contribute to team goals, operational efficiency, high-quality care, special projects, process enhancements, and mentoring.

⛳️ Requirements

• A minimum of 2 years of experience in a health-related field.

• At least 2 years of customer service experience.

• Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).

• Capability to effectively use Microsoft Office tools within the Care Manager Specialist role.

• Access to a private, dedicated workspace to perform duties effectively.

• Dependents must have separate care arrangements during working hours.

• Experience in or willingness to thoroughly learn about care management within Medicare and Medicaid managed care.

• Knowledge of community resources and services.

• Ability to navigate and utilize healthcare technology tools.

• Strong verbal and written communication skills.

• Exceptional customer service and engagement abilities.

• An Associate’s Degree with relevant experience in a healthcare-related field OR a Practical Nurse Degree/Certificate with active licensure that meets state requirements (REQUIRED).

• A Bachelor’s Degree in healthcare or a related field (PREFERRED).

• Bilingual skills, particularly in English-Spanish (PREFERRED).

🏝️ 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 that support physical, emotional, and financial well-being.