Care Management Associate; Remote

Position: Care Management Associate (Remote)
Location: Indiana

Care Management Associate (Remote) page is loaded## Care Management Associate (Remote) remote type:
Remote locations:
IL - Work from home:
Work At Home-Indiana:
Work At Home-Michigan:
Work At Home-Minnesota time type:
Full time posted on:
Posted Todaytime left to apply:
End Date:
January 17, 2026 (4 days left to apply) job requisition :
R0798848

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
** Position Summary
** CVS Health Aetna has an opportunity for a full-time Care Management Associate.  In this role you will support 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.
** Key Responsibilities
*** Responsible for initial review and triage of Care Team tasks.
* Screens patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
* Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs.
* Utilizes eTUMS and other 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.
* 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. ( )
** Remote Work Expectations
*** This is a 100% remote role; candidates must have a dedicated workspace free of interruptions.
* Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
** Required Qualifications
*** 2-4 years experience as a medical assistant, office assistant.
* Must have computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.
** Preferred Qualifications
*** Effective communication, telephonic and organization skills.
* Familiarity with basic medical terminology and concepts used in care management.
* Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
* Ability to effectively participate in a multi-disciplinary team including internal and external participants.
** Education
* ** High School Diploma or G.E.D. required.
** Anticipated Weekly Hours
** 40
* * Time Type
**…