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Aetna is now a CVS Health Company

Care Management Associate

Primary Location: Blue Bell, PA
Additional Locations: PA-Blue Bell
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Description:
  • The care management associate (CMA) role supports medical services including precert intake and sending to clinical, verifying discharges, along with outreach to members.
  • Hiring shift starts at 12:30-9pm. Coverage on Saturday and Holidays may be required on a volunteer basis.


Fundamental Components:
  • Responsible for initial entry of precert cases
  • Screens medical services incoming calls
  • Outgoing calls for entry of appropriate discharge dates and dispositions
  • Identifies triggers for referral to case management or other specialty programs
  • Utilizes ATV and other Aetna systems to enter, build and research and enter information as needed
  • Performs non medical research pertinent to maintain cases
  • Provides support services to team members by answering telephone calls, taking messages, and researching information and assisting in solving problem
  • Making outreach calls to members to explain programs


Background Experience:
  • 2-4 years experience as a medical assistant, office assistant, or customer service.
  • High School Diploma or G.E.D.


Additional Job Information:
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.Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.Ability to effectively participate in a multi-disciplinary team including internal and external participants.

Required Skills:
Benefits Management - Interacting with Medical Professionals, Service - Demonstrating Service Discipline, Service - Handling Service Challenges

Desired Skills:
Service - Creating a Differentiated Service Experience, Service - Working Across Boundaries, Technology - Leveraging Technology

Functional Skills:
Customer Service - Customer service - production environment

Potential Telework Position:
Yes

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Click To Review Our Benefits (PDF)

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