Care Management Specialist

This is a fully remote position, open to applicants in Florida, +6 more states.

📋 Description

• Communicate with members via telephone for 50–75% of the workday.

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

• Complete annual Health Risk Assessment Surveys.

• Perform outreach to members utilizing available resources.

• Create personalized care plans in collaboration with members.

• Record care management activities in electronic health records.

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

• Connect members to health plan benefits and community resources.

• Fulfill regulatory requirements within designated timelines.

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

• Contribute to team goals and enhance operational efficiency.

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

• Assist 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.

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

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

• Must have access to a private, dedicated workspace to perform duties effectively.

• Dependents should have separate care arrangements during working hours.

• Associate’s Degree along with relevant experience in a healthcare-related field (REQUIRED).

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

• Familiarity with community resources and services.

• Ability to navigate and utilize healthcare technology tools.

• Capability to meet performance and productivity standards.

• Strong verbal and written communication skills.

• Excellent customer service and engagement abilities.

• Preferred: Experience providing care management for Medicare and/or Medicaid members.

• Preferred: Experience working with individuals facing SDoH challenges, chronic medical conditions, and/or behavioral health issues.

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

• Preferred: Bilingual skills, particularly in English and Spanish.

🏝️ 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.