Case Management Specialist (Remote, EST) at CVS Health

Yes, the position is remote and based in the EST time zone.

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.

Essential competencies include the ability to meet performance metrics like call volume and member engagement, professional conduct with integrity and self-direction, care management knowledge with willingness to learn, and experience collaborating with RN Care Managers for clinical decision-making.

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 especially with the RN Care Manager for clinical expertise.

Strong candidates have experience or willingness to learn care management, the ability to meet productivity metrics like call volume and engagement, professional integrity, and skills in telephonic outreach, documentation, and interdisciplinary collaboration.