Case Manager, RN

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🔥 1 hour ago

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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

• telephonically assessing, planning, implementing and coordinating all case management activities with members from our Federal Plans • evaluating the medical needs of the member in order to facilitate and promote the member’s overall wellness • developing a proactive course of action to address issues presented to enhance the member's short and long term outcomes • applying data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs • conducting comprehensive clinical assessments • evaluating needs and developing flexible approaches based on member needs, benefit plans or external programs/services • advocating for patients to the full extent of existing health care coverage • promoting quality, cost effective outcomes, and making suggestions to improve program/operational efficiency • identifying and escalating quality of care issues through established channels • providing an expected very high level of customer service • utilizing assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change • utilizing influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health

🎯 Requirements

• Must have active, current and unrestricted RN licensure in state of residence and have the ability to be licensed in all non-compact states • Must be willing and able to work Monday through Friday, 8 hour shift between 7am to 5pm Arizona time • Must live in either PST, MST, or Arizona Time zones • 3+ years of clinical practice experience required • 1+ years of experience utilizing MS Office suites • Case management experience preferred • Case Manager Certification • Associate's degree required • BSN preferred

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package

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