Case Manager, Registered Nurse – Field

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🕒 March 4

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• Visiting members in their homes to evaluate for appropriateness for waiver services, writing the waiver and submitting for approval • Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness • Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits • Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning • Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality • Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members • Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences • Utilizes case management processes in compliance with regulatory and company policies and procedures • Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

🎯 Requirements

• Registered Nurse with active MI state license in good standing • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually • Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills • Ability to work independently • Effective computer skills including navigating multiple systems and keyboarding • Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint • Care Management, discharge planning and/or home health care coordination experience preferred • Certified Case Manager preferred. • Associate's Degree required. Bachelor's degree preferred

🏖️ Benefits

• Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs including wellness screenings, tobacco cessation, and weight management programs • Confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access

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