Care Management Associate

Job Description
This Care Management Associate (CMA) position is 100% remote and preference is for the employee to live within 45 minutes of San Antonio, Texas.

This role is with Aetna supporting the dedicated Costco Team.

Normal Working Hours: Monday through Friday between the hours of 10:00 AM – 7:00 PM CST.

There is no travel required with this position.

The Care Management Associate supports comprehensive coordination of medical services including Care team intake, screening, and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.

The Care Management Associate:
-Responsible for initial review and triage of Care Team tasks.
-Identifies principal reason for admission, facility, and member product to correctly apply intervention assessment tools.
-Utilizes Aetna systems to build, research and enter member information, as needed.
-Support the Development and Implementation of Care Plans.
-Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively)
-Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases
-Provides support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems.
-Adheres to Compliance with PM Policies and Regulatory Standards.
-Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
-Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
-May assist in the research and resolution of claims payment issues.
-Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures.

Pay Range
The typical pay range for this role is:
Minimum: 18.50
Maximum: 34.60

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
-1+ years of experience with computers including knowledge of Microsoft Word, Outlook, and Excel  
-2 years of experience in either customer service, telemarketing and/or sales  
-Requires long periods of sitting and telephone and computer work.

Preferred Qualifications
-Data entry and documentation within member records
-Proficiency in typing for keying in information and navigating in multiple systems
-Ability to work independently with remote support.
-Excellent attendance record
-Medical office experience
-Call center experience
-Medical terminology knowledge
-Strong telephonic communication skills
-Strong organizational skills with an ability to prioritize tasks to meet time-sensitive deadlines
-Effective verbal and written communications skills with both customers and teammates

Education
High School diploma or equivalent years of experience.

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.