[Remote] Care Management Specialist at CVS Health

Florida City, Florida, United States

CVS Health Logo
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

  • 2+ years of experience in a health-related field
  • 2+ years of customer service experience
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) and ability to effectively utilize these tools within the Care Manager Specialist role
  • Access to a private, dedicated space to conduct work effectively to meet the requirements of the position

Responsibilities

  • Dedicate 50-75% of the day to telephonic engagement with members and coordinating their care
  • Utilize all available resources to connect with and engage “hard-to-reach” members
  • Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs
  • Maintain meticulous documentation of care management activities in the member’s electronic health record
  • Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition
  • Identify and connect members with health plan benefits and community resources
  • Meet regulatory requirements within specified timelines
  • Consult with the Care Manager RN within the Care Team for clinical knowledge, medication regimes, and supportive clinical decision making
  • Collaborate and leverage the Care Manager RN clinical expertise to ensure members’ needs are adequately addressed
  • Support team objectives, enhance operational efficiency, and ensure delivery of high-quality care to members (including participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members)

Skills

Key technologies and capabilities for this role

Care ManagementTelephonic EngagementHealth Risk AssessmentCare PlanningDocumentationInterdisciplinary CollaborationSocial Determinants of HealthMember OutreachCommunity Resources

Questions & Answers

Common questions about this position

Is this a remote position or does it require office work?

This information is not specified in the job description.

What are the key responsibilities of the Care Management Specialist?

Key responsibilities include telephonic engagement with members (50-75% of the day), member outreach to hard-to-reach individuals, developing individualized care plans, documentation in electronic health records, collaboration with the interdisciplinary care team, connecting members to resources, and ensuring regulatory compliance.

What salary or compensation does this role offer?

This information is not specified in the job description.

What is the team structure like for this role?

The role is part of an interdisciplinary care team including the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other participants, with close collaboration and consultation with the Care Manager RN for clinical decisions.

What makes a strong candidate for this Care Management Specialist position?

Strong candidates demonstrate ability to meet performance metrics like call volume and member engagement, conduct themselves with integrity and professionalism, have care management knowledge or willingness to learn, and experience in telephonic engagement and collaboration with healthcare teams.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters
1963Year Founded
DEBTCompany Stage
Healthcare, Consumer GoodsIndustries
10,001+Employees

Benefits

Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Disability Insurance
401(k) Retirement Plan
Company Equity
Wellness Program
Professional Development Budget
Paid Vacation
Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.
The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.
The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.
The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.
CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.
Increased consumer interest in wellness boosts demand for CVS's health-related products.
The trend towards value-based care aligns with CVS's integrated healthcare approach.

Land your dream remote job 3x faster with AI