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CVS Health logo
CVS Health

Bringing our heart to every moment of your health.

Case Management Coordinator, Assessor Team (Remote)

Clinical OperationsClinical OperationsOtherRemoteMid LevelTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

100 days ago

Salary

$21 - $45 / hour

Seniority

Mid Level

Job Description

Case Management Coordinator, Assessor Team (Remote)

CVS Health

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 Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. 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. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, The Case Management Coordinator facilitates appropriate healthcare outcomes for members by aiding with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. Key Responsibilities - Evaluation of Members: -Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available - internal and external programs/services. - Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates and implements assigned care plan activities and monitors care plan progress. - Enhancement of Medical Appropriateness and Quality of Care: - Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes. - Identifies and escalates quality of care issues through established channels. - Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs. - Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. - Helps member actively and knowledgably participate with their provider in healthcare decision-making. - Monitoring, Evaluation and Documentation of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Remote Work Expectations - This is a remote-hybrid 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 - Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (nursing, psychology, social work, marriage and family therapy, counseling). - Must have computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Preferred Qualifications - Case management and discharge planning experience preferred - 2 years’ experience in behavioral health, social services or appropriate related field equivalent to program focus - Managed Care experience preferred - Effective communication, telephonic and organization skills - Excellent analytical and problem-solving skills - Ability to work independently - Ability to effectively participate in a multi-disciplinary team including internal and external participants. Education: Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services required (nursing, psychology, social work, marriage and family therapy, counseling). Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10 - $44.99 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/03/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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Associate Director, Clinical Site Budgets & Payments

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Jade Biosciences is a clinical-stage biotechnology company focused on developing best-in-class therapies that address critical unmet needs in autoimmune diseases. Jade’s lead candidate, JADE101, targets the cytokine APRIL, and is currently being evaluated in a Phase 1 clinical trial for the treatment of immunoglobulin A nephropathy. Jade’s pipeline also includes JADE201, an afucosylated anti-BAFF-R monoclonal antibody, as well as JADE301, an undisclosed antibody candidate, both currently in preclinical development.

OtherRemoteTeam 11-50

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Associate Director, Clinical Site Budgets & Payments will architect and lead the company’s global approach to clinical trial site budgeting, investigator grant strategy, transparency compliance, and site/vendor payment governance across our clinical trial portfolio. This leader will define Jade’s global investigator grant philosophy, including structured opening offer and negotiation parameters that ensure speed, fairness, and alignment with global FMV benchmarks. They will establish standards for invoiceables, conditional procedures, pass‑through costs, and country‑specific budgeting norms that apply across all Jade clinical studies. This role oversees a full‑service CRO partner responsible for operational execution of budgets, payments, reconciliation, and study financial controls. 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United States
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OtherRemoteTeam 10,001+Since 1963H1B No Sponsor

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 flexible, work‑from‑home role requires up to 75% travel for in‑home member visits and follows a Monday–Friday, 8:00am–5:00pm CST schedule. The Case Manager delivers high‑quality, member‑centered care by conducting comprehensive in‑home assessments, developing individualized care plans, and coordinating services across physical, behavioral, and social needs for the pediatric demographic (0-21). Using advanced clinical judgment and strong critical‑thinking skills, the Case Manager collaborates with providers, interdisciplinary teams, and member support systems to ensure safe, cost‑effective care and optimal outcomes. Key responsibilities include facilitating access to Long‑Term Services and Supports (LTSS), advocating for members during care transitions, monitoring progress toward care goals, and documenting timely and accurately in the electronic health record. The role requires exceptional assessment, communication, and writing skills, along with the ability to motivate members, address barriers, and support informed decision‑making. Required Qualifications - Active and unrestricted RN license in the state of TX - 2+ years of clinical experience - Must reside in Rockwall, Collin, or Dallas County of TX - Must possess reliable transportation and be willing and able to travel up to 75% of the time in Denton County, Collin County, Dallas County or surrounding counties - Mileage is reimbursed per our company expense reimbursement policy Preferred Qualifications Case Management and/or home health care experience Managed care organization (MCO) experience Pediatric experience Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

United States
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Job Closed
OtherRemoteTeam 10,001+Since 1963H1B No Sponsor

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 Case Management Coordinator (i.e. CC) utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. 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Required Qualifications - 2+ years experience in behavioral health or social services - Candidate must have the ability to work 8:00 AM - 5:00 PM in assigned market time zone - 2+ years of experience with Microsoft Office Applications (Word, Excel, Outlook) - 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 Preferred Qualifications - Case management and discharge planning experience - Managed care experience Education - Bachelor's Degree or non-licensed master level clinician with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling) or equivalent experience (REQUIRED) Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10 - $40.90 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. 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United States + 1 moreAll locations: United States | Trinidad And Tobago
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Job Closed

Supervisor Medical Clinical Operations

UnitedHealth Group

UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position is Remote in Maine. If you are located within commutable distance to the office at 43 Whiting Hill Rd. Brewer ME 04412, you will have the flexibility to work remotely as you take on some tough challenges. This position directly supervises Patient Access staff. The Supervisor ensures the department is adequately staffed to fulfill daily operations, and assists leadership in keeping statistical records, monitoring measurable metrics / KPIs and performing audits as necessary. This position will act as a subject matter expert for applicable workflows, metrics, and applications, addressing team needs and escalating as appropriate. This position is full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00 am - 5:30 pm EST. It may be necessary, given the business need, to work occasional overtime. This will be on the job training and the hours during training will be 8:00 am - 4:30 pm EST, Monday - Friday. Primary Responsibilities: - Directly supervises the Access Center Associates and supports the Manager of Access Services in ensuring associates meet performance and productivity expectations. - Prepares and distributes department documents or information as designated by the department manager. - Addresses employee questions and needs, to find appropriate and timely resolution. - Audits staff performance and holds routine rounding with employees to address error resolution, goal setting, and encourage efforts. - Completes disciplinary actions when appropriate and shares with the manager for review when necessary (written warning or above). - Serves as the first point of escalation to assist with customer questions, complaints, or needs. - Monitors and strives to exceed KPIs and department goals. Assists managers with associated LEM goals. - Maintains a safe environment for healthcare workers, patients, and/or visitors complying with Northern Light/Optum policies and procedures. - Maintains and exhibits a current knowledge of profession and participates in continuing education. - May perform other duties upon request. Qualifications - High School Diploma / GED OR equivalent work experience. - Must be 18 years of age OR older. - 3+ years of related experience within Patient Access functionality. - Working knowledge of computer-related skills to send and receive emails, type general correspondence, and enter data into spreadsheets or other software applications. - Must be within travelling distance to 43 Whiting Hill Rd. Brewer ME 04412. - Ability to work on site at least 1 day a week. - Ability to work full time (40 hours / week), Monday - Friday. - Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00 am - 5:30 pm EST. - It may be necessary, given the business need, to work occasional overtime. Preferred Qualifications - 1+ years of leadership experience. Telecommuting Requirements - Reside within commutable distance to the office at 43 Whiting Hill Rd. Brewer ME 04412. - Ability to keep all company sensitive documents secure (if applicable). - Required to have a dedicated work area established that is separated from other living areas and provides information privacy. - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. Soft Skills - Demonstrates system values and integrates them into daily organizational practice. - Actively supports patient-centered care with respect for the diversity of human experience and demonstrating integrity with the handling of sensitive financial information. - Ability to delegate work, set clear direction, and manage workflow. - Verbal and written aptitude for adequate communication with the general public, providers, physician office staff, registration staff, and other healthcare professionals. - Ability to navigate and utilize system applications and associated materials needed to perform duties. - Self-driven with an ability to multitask and prioritize based on daily needs. - Strong coaching and mentoring skills. Ability to train staff and develop subordinate's skills. Ability to foster teamwork among staff members. - Exceeds department productivity standards. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). Salary Information The salary for this role will range from $60,200 - $107,400 annually based on full-time employment.

United States
Job Closed