Case Manager, RN

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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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

• Assess members' health status and care coordination needs • Conduct inpatient review and discharge planning • Develop, implement, monitor, and evaluate case management plans • Involve the Medical Director as indicated and close cases when discharge criteria are met • Identify members using data-driven methods to create individualized case management programs and referrals • Conduct comprehensive clinical assessments • Evaluate needs and develop flexible approaches based on member needs, benefit plans, or external programs/services • Advocate for patients within existing healthcare coverage • Promote quality, cost-effective outcomes and suggest improvements to program and operational efficiency • Identify and escalate quality-of-care issues through established channels • Provide a very high level of customer service • Assess members' health literacy, technology capabilities, and readiness to change • Use influencing and motivational interviewing skills to maximize member engagement and promote lifestyle and behavior changes • Provide coaching, information, education, and support to empower members to make independent medical and healthy lifestyle choices • Collaborate with available resources through assessment, planning, facilitation, and advocacy to promote optimal outcomes

🎯 Requirements

• Active and unrestricted RN license in their state of residence • Ability to obtain multi-state licensure upon hire • 3+ years of acute care experience as an RN • 3+ years of experience with Microsoft Suite of products • 2+ years of Oncology Care experience • Minimum of Associate Degree in Nursing required • Compact RN License preferred • Certified Case Manager (CCM) preferred • Case Management experience preferred • Managed Care experience preferred • Telephonic case management and/or telephonic customer service center experience preferred • Availability for Monday-Friday working hours, an evening rotation several times per quarter, and rotational coverage of evenings, weekends and holidays as needed

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay