Care Management Associate

Job DescriptionThe Care Management Associate position in the Engagement Hub is a 100% remote, work from home position and the candidate can live in any state.Normal Working Hours: Monday through Friday 11:30am - 8:00pm EST (8:30am-5:00pm PST). The current need of the team is to provide coverage until 8:00pm EST and is non-negotiable. The employee will work a set schedule but will require some flexibility to cover shifts within the time frame of 8:00am-9:00pm EST.There are currently no weekend or holiday shifts required in the Engagement Hub.There is no travel required with the position.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 telephoneRequired Qualifications-1+ years of 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 ESTCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications-Data entry and documentation within member records-Background in health care setting -Call center experience-Familiarity with basic medical terminologyEducationHigh School diplomaBusiness OverviewBring your heart to CVS HealthEvery 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.

Created: 2025-11-15