Employer: CVS Health
This Care Management Associate position is a 100% remote, work from home position and the candidate can live in any state.
The normal working hours for this position are Monday through Friday from 12:30pm-9:00pm EST.
There are currently no weekend or holiday shifts required in the Engagement Hub.
We are building an exciting new clinical and member experience program for Aetna Commercial members.
The Care Management Associate is the front line of customer service for Aetna Commercial members, responsible for the outreach to and enrollment of our eligible members. Our Care Management Associates demonstrate a highly energetic blend of salesperson, health care navigator and health plan customer support representative.
The Care Management Associate is responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified Commercial members to care management services.
Care Management Associate Job Duties Include:
- Responsible for initial case review including confirming eligibility using appropriate systems available prior to initiating outreach
- Initiates engagement with assigned members to introduce the Aetna Care Management Program and gather updated member demographic information with the goal of enrolling the member in the program
- Effectively meets daily metrics with speed, accuracy, and a positive attitude with a focus on number of outbound dials and effectiveness in enrolling members into Aetna Care Management Programs
- Completes assignment of members to appropriate case managers based on defined assignment criteria i.e. availability and licensure
- Accurately and consistently documents each call in the members electronic record, thoroughly completing required actions with a high level of detail to ensure Compliance and Regulatory Standards are met
- Protects the confidentiality of member information and adheres to company policies regarding privacy/HIPAA
- Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
- Ability to be agile, managing multiple priorities and adapting to change with enthusiasm
- Determined to build strong relationships with peers and our Aetna members
- Demonstrates an outgoing, enthusiastic, and caring presence over the telephone
- Experience with computers including knowledge of Microsoft Word, Outlook, and Excel
- 2 years of work experience (preferably in customer service, telemarketing, or sales)
- Flexibility to work outside of standard business hours which can span from 8:00 am to 9:00 pm EST
- Strong organizational skills, including effective verbal and written communications skills
CVS Health requires its Colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work. If your request for an accommodation is not approved, then your employment may be terminated.
- Data entry and documentation within member records
- Background in health care setting
- Call center experience
- Familiarity with basic medical terminology
- High School diploma