Case Manager – Registered Nurse, Telehealth

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and facilitate the member’s overall wellness. • Develop a proactive course of action to address the issues presented to enhance their short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. • Use clinical tools and information/data review to conduct an evaluation of members’ needs and benefits. • Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning. • Conduct assessments that consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. • Use a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members. • Collaborate with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives. • Utilize case management processes in compliance with regulatory and company policies and procedures. • Utilize motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. • Work on behalf of the client and the member's provider.

🎯 Requirements

• Registered Nurse that must reside in the Continental United States • hold an unrestricted nursing license with multi-state/compact privileges and have the ability to be licensed in all non-compact states • 3+ years clinical/nursing practice experience • High speed internet- ability to hard wire computer. • 1+ year(s) of medical case management experience, care coordination or discharge planning. • 3+ years of experience with personal computers, keyboarding, multi-systems navigation, and MS Office Suite applications • Work from Home Requirements: You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. • WiFi and satellite internet are not permitted. • A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours. • Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live. • The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility