Care Management Specialist

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

📋 Description

• Coordinate care for members of the Special Needs Plan, especially those facing social determinants of health challenges and maintaining stable health conditions.

• Complete annual Health Risk Assessment Surveys and address issues related to social determinants of health.

• Close gaps in preventive care and health maintenance.

• Engage with members via phone for 50–75% of the workday.

• Conduct outreach to members who are difficult to reach.

• Create personalized care plans in collaboration with members.

• Document care management activities within members’ electronic health records.

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

• Connect members to 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, special projects, process improvements, and the mentoring of new team members.

⛳️ Requirements

• 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).

• Capable of effectively utilizing Microsoft Office tools in the role of Care Manager Specialist.

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

• Dependents must have alternative care arrangements during work hours.

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

• Experience in care management for Medicare and/or Medicaid members.

• Experience working with individuals facing social determinants of health needs, chronic medical conditions, or behavioral health issues.

• Experience in conducting health-related assessments and facilitating care planning processes.

• Bilingual abilities, particularly in English and Spanish, are 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 to support physical, emotional, and financial well-being.