Provides telephonic and occasional in-person case management and care coordination for Medicare members, including assessment, care planning, documentation, liaison with providers and stakeholders, and facilitation of services across the continuum of care. Requires compact RN licensure and multiple years of clinical and case management experience; work-from-home with specified internet and workspace requirements.

CVS Health is hiring an Inbound Patient Account Services Coordinator to provide customer service for patient billing and reimbursement inquiries, document interactions in revenue cycle systems, determine eligibility for payment plans, meet call center metrics, and coordinate with other departments. Requires at least 6 months of healthcare billing/reimbursement/collections or infusion services experience and proficiency with Microsoft Word, Outlook, and Excel. Full-time, 40 hours/week; typical shifts between 8:00am–8:00pm EST.

Inbound Patient Account Services Specialist (remote) supporting patients with billing, reimbursement, eligibility, and payment-plan discussions. Requires minimum 6 months healthcare billing/reimbursement/collections or infusion services experience, verifiable high-school diploma or GED, and Microsoft Word/Outlook/Excel familiarity. Full-time (40 hrs/wk) with 8-hour shifts within 8:00am–8:00pm EST; pay range $17.00–$28.46/hour.

The Utilization Management Nurse Consultant conducts clinical information gathering and criteria-based coverage determinations, communicates with providers, identifies referral opportunities, and supports utilization/benefit management. This full-time, remote work-from-home role requires an active, unrestricted RN license in the state of residence, at least 2 years of clinical hospital (adult acute/critical care) experience, and the ability to meet technical/home office connectivity requirements. Pay range listed: $32.01–$68.55.

100% remote Utilization Management Nurse role responsible for applying clinical judgment and evidence-based criteria to review inpatient and outpatient behavioral health and substance abuse services, authorizing care, collaborating with providers, and escalating cases as needed. Requires active unrestricted RN licensure in state of residence, 3+ years acute behavioral health/substance abuse nursing experience, and 1+ year concurrent review or prior authorization experience.

Oak Street Health / CVS Health is hiring a full-time Medical Scribe to document patient encounters, assign ICD-10 and CPT codes, support clinical documentation improvement, and assist provider teams. Role is based in Sun City, AZ (10705 W Peoria Ave) with a hybrid-remote option after a 90-day training period (typically 2 days remote / 3 days onsite). Hourly pay range listed: $17.00–$28.46. Candidates must have US work authorization and commit to approximately 40 hours per week.

Full-time (40 hrs/week) remote Contact Center Service Advocate I responsible for appointment scheduling, patient communication, data entry into scheduling/EMR systems, follow-up calls, and resolving scheduling issues. Requires ~1 year customer service experience (call center preferred); Spanish, Mandarin, Cantonese, or Polish speakers preferred. Pay range: $17.00–$34.15/hr. US work authorization required.

Full-time (40 hrs/wk) remote Health Advocate on the Healthy Outcomes Team conducting inbound and outbound calls to Medicare members and providers to encourage screenings, vaccinations, medication adherence and other services. Requires high computer literacy, proficiency with Windows and web-based tools, hard-wired high-speed internet (≥50 Mbps), and a suitable remote workspace. High school diploma or GED required. Bilingual candidates and experience with HEDIS, call center/outreach, or healthcare settings are heavily preferred. Pay range: $17.00–$28.46/hr.

CVS Aetna seeks a full-time, 100% remote Appeals Nurse Consultant to review and resolve clinical appeals (including UM, MPO, Coding, or Behavioral Health). Requires active unrestricted RN licensure in state of residence, a minimum of 3 years clinical experience, and at least an Associate's degree. Standard hours are Monday–Friday, 8:00 AM–5:00 PM local time; occasional weekend/holiday on-call coverage may be required.