Care Management Specialist

This is a fully remote position, open to applicants in Florida, +12 more states.

📋 Description

• Engage with members via telephone for 50–75% of the workday while coordinating their care.

• Conduct annual Health Risk Assessment Surveys.

• Address the social determinants of health needs for members.

• Close gaps in preventive and health maintenance care.

• Utilize available resources to reach hard-to-engage members.

• Create individualized care plans with members that include goals and interventions.

• Document care management activities in the electronic health records of members.

• Collaborate with the Interdisciplinary Care Team to tackle barriers to care and uphold stable health conditions.

• Connect members with health plan benefits and community resources.

• Comply with regulatory requirements within set timelines.

• Consult with the Care Manager RN regarding clinical knowledge, medication regimens, and clinical decision-making.

• Support team objectives and enhance operational efficiency.

• Participate in special projects and initiatives aimed at process improvement.

• Aid in mentoring new team members.

⛳️ Requirements

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

• At least 2 years of customer service experience.

• Proficiency in Microsoft Office Suite: Word, Excel, Outlook, OneNote, and Teams.

• Ability to efficiently use Microsoft Office tools in the Care Manager Specialist role.

• Access to a private, dedicated workspace.

• Dependents must have separate care arrangements during work hours.

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

• Familiarity with community resources and services.

• Capability to navigate and utilize healthcare technology tools.

• Strong verbal and written communication skills.

• Excellent customer service and engagement abilities.

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

• Bilingual skills, especially in English and Spanish, are preferred.

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

• Familiarity with SDoH needs, chronic medical conditions, and/or behavioral health is preferred.

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

🏝️ Benefits

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

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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