Case Manager, Registered Nurse

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🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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CVS Health

WebsiteLinkedInAll Job Openings

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

• 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

• 3-5 years of direct clinical practice experience e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills • Ability to work independently • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. • Efficient and Effective computer skills including navigating multiple systems and keyboarding • Case management and discharge planning experience (preferred) • Managed care/utilization review experience (preferred) • Crisis intervention skills (preferred) • Certified Case Manager (preferred) • Bilingual (preferred)

🏖️ Benefits

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