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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.

Job Title: Care Coordination Support Specialist

Overview:

Join our team as a Care Coordination Support Specialist, where you’ll play a vital role in supporting the delivery of high-quality, cost-effective healthcare services. You’ll assist in care team intake, screening, and care plan implementation to ensure members receive the right care at the right time.

Key Responsibilities:

+ Conduct outreach to members to support care coordination efforts.

+ Perform prior authorization reviews and ensure timely completion.

+ Triage and review incoming Care Team tasks for appropriate routing.

+ Identify reasons for admission and apply appropriate assessment tools.

+ Screen patients using business rules to determine service needs and make referrals.

+ Monitor cases for discharge planning and identify outliers for clinical review.

+ Refer members to appropriate programs (e.g., Case Management, Disease Management).

+ Utilize internal systems (e.g., Dynamo) to manage and update member information.

+ Support care plan development and coordinate services under clinical guidance.

+ Promote use of in-network providers and cost-effective care options.

+ Facilitate communication among healthcare providers and internal teams.

+ Conduct non-clinical research to support case management activities.

+ Provide administrative support including call handling, message taking, and issue resolution.

+ Ensure compliance with regulatory standards and maintain accurate documentation.

+ Protect member confidentiality and adhere to company policies.

+ Assist with claims research and support quality and case management processes.

Required Qualifications:

+ Strong knowledge of medical terminology and multitasking abilities.

+ 2–4 years of experience as a medical assistant or in a medical office setting.

+ Experience with call centers (inbound/outbound) and prior authorizations.

+ Comfortable working in a fast-paced environment.

+ Must reside in New Jersey or Pennsylvania

Education:

+ High School Diploma or GED required.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

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: 08/31/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.