Job Description
Job Description
Support comprehensive coordination of the In Touch Care Management program including but not limited to intake, screening, researching and collecting information, performing initial member outreach, scheduling appointments, supporting the implementation of care plans to promote effective utilization of healthcare services, and/or referring members to specialty programs as appropriate, such as Behavioral Health or Womens Health programs. Performs intake of calls from members or providers regarding services via telephone, fax, EDI. Utilizes ASD/ATV and other Aetna systems to build, research and enter member information. Approve services that do not require a medical review in accordance with the benefit plan. Performs non-medical research including eligibility verification, COB, and benefits verification. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements
Required Qualifications
Familiarity with basic medical terminology and concepts used in care management. 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. Effective communication, telephonic and organization skills. Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions. Hours of operation are 5:00 AM-5:00 PM AZ time (CMA on a rotating schedule to cover hours of operation. Rotation is week to week).
Preferred Qualifications
2-4 years experience as a medical assistant, office assistant. Proficient with navigation thru multiple systems and dual monitors ability to touch type at efficient speed.
Education
High School diploma, G.E.D. or equivalent experience
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
Support comprehensive coordination of the In Touch Care Management program including but not limited to intake, screening, researching and collecting information, performing initial member outreach, scheduling appointments, supporting the implementation of care plans to promote effective utilization of healthcare services, and/or referring members to specialty programs as appropriate, such as Behavioral Health or Womens Health programs. Performs intake of calls from members or providers regarding services via telephone, fax, EDI. Utilizes ASD/ATV and other Aetna systems to build, research and enter member information. Approve services that do not require a medical review in accordance with the benefit plan. Performs non-medical research including eligibility verification, COB, and benefits verification. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements
Required Qualifications
Familiarity with basic medical terminology and concepts used in care management. 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. Effective communication, telephonic and organization skills. Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions. Hours of operation are 5:00 AM-5:00 PM AZ time (CMA on a rotating schedule to cover hours of operation. Rotation is week to week).
Preferred Qualifications
2-4 years experience as a medical assistant, office assistant. Proficient with navigation thru multiple systems and dual monitors ability to touch type at efficient speed.
Education
High School diploma, G.E.D. or equivalent experience
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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