Registered Nurse – Transition of Care

Job not on LinkedIn

🔥 1 minute ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Complete market-specific post-discharge assessments to identify member needs, including Health Related Social Needs and Social Determinants of Health • Provide comprehensive discharge planning and facilitate transitions between institutional and community settings • Ensure members have received medications and understand how to take them • Determine appropriate services and supports, including prior authorizations, provider coordination, condition management education, medication management, and community resources • Identify barriers to optimal member health and apply strategies to reduce member risk • Lead and coordinate Interdisciplinary Care Teams to develop and implement Individualized Care Plans • Coordinate care with interdisciplinary teams to support optimal wellness and self-management • Coordinate post-discharge meal delivery, secure durable medical equipment, and ensure timely physician follow-up • Educate members and caregivers on care plans, medications, and community resources • Explain payer and plan benefits, policies, and procedures to providers, members, and personnel • Update care plans when conditions or behavioral health status change • Review prior claims and assessments to identify case management, eligibility, and clinical resource needs • Complete outreach cadence calls and post-discharge questionnaires within compliance timelines • Schedule follow-up appointments and complete medication reconciliation • Identify and address barriers such as transportation, housing, and medication access • Use weekly and daily reporting to reduce emergency department utilization and 30-day hospital readmissions • Follow members from inpatient admission through the care continuum until return to prior community functioning • Facilitate interdisciplinary meetings with Social Services, Care Management, PCPs, and other stakeholders • Ensure compliance with state and federal regulations, including NCQA standards

🎯 Requirements

• Active and unrestricted Registered Nurse (RN) License in Illinois • 3+ years of clinical practice experience • 1+ year(s) of experience in care coordination or working with high-risk populations • Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams • Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually • Access to a private, dedicated space to conduct work effectively • Associate’s Degree in Nursing (REQUIRED) • Working knowledge of LTSS and HCBS options, chronic disease management, medication side effects, health equity and cultural competency, community-based services and public benefits • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills • Ability to work independently, multitask, prioritize, and adapt to a fast-paced changing environment • Must have or be able to obtain a direct/hardwired internet connection within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently residing • Must provide own workspace furniture • Comfortable setting up and using multiple monitors and navigating multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to access secure systems such as VPN and EHR portals, lock computer screens, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Openness to learning new skills • Bilingual is preferred • Certified Case Manager is preferred • Bachelor’s Degree in Nursing is preferred

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment including keyboard, monitor, computer, headset, etc.