Care Mgt Associate Jobs

Care Mgt Associate — OH - Work from hom. Apply via Workday.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Associate Practice Manager Company: Oak Street Health Role Description: The purpose of an Associate Practice Manager at Oak Street Health is to lead and manage operations at a single primary care clinic location in accordance with company values and standards. Associate Practice Managers supervise clinical and non-clinical team members, support operational initiatives, drive their team towards achieving patient satisfaction and clinical outcomes measured via a variety of metrics, and generally ensure the clinic is running smoothly and in a timely manner on a daily basis. Core Responsibilities: Staff Management and Development Hire, train, supervise, coach, mentor and manage a multi-disciplinary team of 15+ Ensure the center is a Great Place to Work and our teams are engaged and thriving; build a culture of engagement and demonstrate the Values and Service Behaviors at all times Clinic Operations Ensure clinic operations are running smoothly and safely on a daily basis, including ensuring there is adequate staffing each day, arranging coverage for any call-offs or scheduled PTO and ensuring that all Standard Operating Procedures are followed Ensure that we are providing an Unmatched Patient Experience and provide service recovery as needed Drive result

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Manager, Care Model is responsible for owning the day‑to‑day execution of a defined care model workstream, ensuring planned activities are delivered on time and with high quality. This role translates care model strategy and direction into detailed task‑level plans, coordinates functional contributors, and drives daily follow‑through on actions, milestones, and deliverables. The Manager focuses on tactical execution, detailed tracking, and issue management, proactively identifying risks and escalating impacts that may affect the broader care model timeline. This role serves as a key operational partner to the Workstream PM and Senior Care Model leadership by providing accurate status, maintaining workstream artifacts, and ensuring reliable inputs into integrated reporting. Own day‑to‑day execution of a defined care model workstream, delivering tasks and milestones as planned Develop and maintain task‑level work plans; track actions, owners, dependencies, and due dates Coordinate functional contributors to support timely completion of workstream deliverables Identify and manage workstream‑level risks and issues; propose mitigation options and timing impacts Escalate risks, issues, or slippage impacting the broader care model critical path Provide accurate, timely status updates and inputs to integrated workstream reporti

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job Purpose and Summary As an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly those with social determinants of health (SDoH) needs and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants to support the member in maintaining optimal health. This is achieved by evaluating the members’ needs through the completion of the annual Health Risk Assessment Survey, addressing SDoH needs, and closing gaps in preventative and health maintenance care. Key Responsibilities Telephonic Engagement: Dedicate 50-75% of the day to engaging with members and coordinating their care. Member Outreach: Utilize all available resources to connect with and engage “hard-to-reach” members. Care Planning: Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs. Documentation: Maintain meticulous documentation of care management activities in the member’s electronic health record. Collaboration: Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable h

Become a part of our caring community The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Reports to the Regional CM Manager. Use your skills to make an impact Required Qualifications Must have an active, unrestricted SC Licensed Masters Social Worker (LMSW), Licensed Professional Counselor (LPC) OR an active, unrestricted compact Registered Nurse (RN) license . 2 or more years of experience working as a behavior

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position is open to candidates located in Arizona. The work schedule is Monday through Friday, from 8:30 AM to 5:00 PM Arizona time. The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review. Additional responsibilities include but not limited to the following: - Evaluates 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 by the benefit plan. - Communicates health care service delivery as required based on outcomes/reviews noted by the nurse or medical director - Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases. - Provides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropria

Become a part of our caring community As a Care Management Support Assistant, you will help members take the next step toward better health and well-being. You will do this by connecting with them over the phone, completing important non-clinical assessments, identifying barriers to care, and helping them access resources and benefits. We are looking for people who show compassion and document customer issues in detail, can work in a call center environment, and motivate themselves through work that directly supports members and care teams. This is a remote position, and the assigned shift will be 11:30 AM–8:00 PM Eastern Standard Time. Job Description What You Will Do Engage members by phone to encourage participation in care management programs. Complete required assessments and questionnaires to help identify health risks, care needs, and opportunities for clinical team follow-up. Assist members who need support scheduling doctor’s appointments or connecting with appropriate care resources. Identify and help address barriers to preventive screenings, benefits, and health-related services so members can close gaps in care. Support members in understanding, retaining, and accessing benefits that contribute to their overall health and well-being. Manage both inbound and outbound calls in an auto-dialer environment while documenting member information. What Success Looks Like You create a positive member experience by treating each interaction with respect, patience, and professionalism You demonstrate compassion, integrity, and sound judgment when supporting members with sensitive health-related needs You listen to

Become a part of our caring community The Care Management Support Assistant contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Management Support Assistant performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. The Care Management Support Assistant will review inbound referrals and correspondence for processing, fulfilment or resolution utilizing all appropriate software systems and resources. Screen physician’s orders and documentation to identify that all qualifying medical documentation and required information is included. When necessary, request additional applicable information from referring entity. Perform verification of benefits coverage and eligibility for services per Health Plan contract. Review referral data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures for approving request or referring request for further review. Provide referral management education to members and providers regarding medical benefits, referral status and prior authorizations. Communicate with patient to confirm demographics and explain the details of the services/care requested. Coordinate the timely delivery of care and services with providers. Also communicate with referring entities, providers, and members regarding final referral determination while maintaining detailed documentation to record patient, physician, referral source and provider interactions and communications. Work with Pre-Authorization, Utilization Management, Billing, Pharmacy, and Home Care r

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Schedule: Monday-Friday 8AM - 5PM Travel: Up to 55-75% travel in and around Yale New Haven, CT. Position Summary Program Overview Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Family Summary/Mission Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies, and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strateg

Care Coordinator, Initiation Team — Illinois. Apply via Workday.

Care Management Associate (Remote - Illinois) — 6 Locations. Apply via Workday.

Care Management Support Assistant — Ohio. Apply via Workday.

Care Manager, Behavioral Health — Remote Nationwide. Apply via Workday.

Care Manager Registered Nurse - Field- Essex County, New Jersey- New Hire Bonus Available! — Field-New Jersey. Apply via Workday.

Care Management Associate - Must live near San Antonio, Texas — TX - Work from home. Apply via Workday.